Renu's Week

Report of 9 Jan 2012

2012-01-09T20:41:00.000-08:00

Wow -

Trying to stay awake is probably harder than trying to get to sleep. I have been prescribed a muscle relaxant and it sedates so much that I think I won't take it tomorrow; I do think I can live with a little pain. I have had some physical therapy, and that is bound to help; I am a huge fan of the allied health professions. The physical therapist is a young lady, very enthusiastic, and she administed Inferential Therapy - or an electric current and heat - to my cramped muscles, and also some ultrasound. It felt good while I was getting it done. I now know why massage is so popular; the touch is therapeutic and soothing. Not to be sexist, but to me, probably a bit more so if the therapist is female: there is just something nurturing about women, isn't there.

Being a patient often clues me in as to how I must be as a doctor.

The B has been wonderful. Our deaf-mute patient, Ms. S, suddenly swelled up all over ("anasarca"). I suspect kidney involvement and asked the nephrologist to see her; Dr. Suresh is a good friend, and a firm believer in care of the indigent, so my patients get fine treatment by him. The official word is that Ms. S has a urinary tract infection, but I do think there is a bit more to it than that. Ms. S is a young person whose uterus is prolapsing (coming out of her main body cavity) and she likely needs surgery for this. When the enthusiastic med students ("The Texas Team" or "The Banyan Bunch") took class on physical diagnosis, the issue of uterine prolapse generated a lot of questions. I remember a resident at St. V (in Indianapolis, where I trained) stating that she would opt for a C-section whenever she got pregnant and was ready to delliver, as she wanted to avoid this very issue. Ms. S is a mystery: she does not know sign language and has asked repeatedly to return to her family. We have absolutely no way of knowing where the family is, and it is fairly frustrating all of us. Perhaps we'll resort to a TV ad before too long, if we come up with some cash.

Vandana and the team of the Banyan Academy of Leadership in Mental Health (BALM) asked me to join them for a meeting about training, and I did. Vandana is a visionary individual, and grand fun, so the meeting was very enjoyable. It was punctuated with a lot of laughter and good humor, too, which epitomises all of what we do at the Banyan. I've been at other assignments where my place in the food chain was made obvious to me and work became humorless after a bit - but that is not the Banyan! We are fairly full of chaos, but also good actions, easy camaraderie, and a sharing of the vision of a 21-year-old and a 22-year-old, both of whom thought they could make a difference in the lives of mentally ill, destitute women - and indeed, did so.

We had 2 British volunteers, Sam and Martha, spend the night with us 2 days ago. They are just about Naren's age, and all enjoyed their company. Following morning, my nephews, Aditya and Vikram, joined us for breakfast at one of our favorite restaurants and that was a grand time: 5 powerfully intelligent youngsters in their 20's, some wonderful sausages, eggs, fresh fruit and all manner of juices, and some scintillating conversation to boot. Martha and Sam were effusive in their appreciation, and I do not know at all what I did to deserve such thanks: we talked, we ate, we hung out - c'est tout.

Naren and I spent a fun Saturday, booking movie tix well in advance and going to see "Mission Impossible 4" and "Sherlock Holmes." MI4 was dreadful, and SH was more enjoyable. I will see a couple of movies now just to stay awake until bedtime. This is one of the things I miss most about the U.S. - walking into a movie theater, tix being available and I sitting wherever I want and watching the flick; in Chennai, we have to book days in advance (for any movie), tix are often sold out and the seats are numbered. Also, a woman going alone to see a movie is extremely unusual.

Navin is fine at Rose-Hulman and is buffing up his driving, as he is due to try for a U.S. driving licence soon. Scott and I talk regularly, and I am super glad he is with his family because running 2 farms can wear anyone out, much less 3 folks in their 70's (Scott's mother, aunt and uncle). These 3 folks are among my favorite people in the world, and I was fortunate to spend some time with them when I was there; I always leave rejuvenated. Scott told me he had had to buy new pants; I watch our budget like a hawk and when I heard that he had helped his uncle with a cumbersome chore, I told him he could buy caviar if he wanted as he had done something for the relatives. Scott laughed out loud: it was a nice sound over a long distance telephone line.

It's a good life, and I feel privileged to be in the profession.

Unw -

R

Report of 03 Jan 2012

2012-01-03T20:37:00.000-08:00

Happy New Year!

The blog is still makkarfying (causing hassles), so I'll have to write thus.

It has been a nice couple of weeks. The students were good fun, and to a person, appear to have liked the Banyan. This is the first time students have spent 2 weeks here. (A beloved friend, Greg Brown, came as a student, then an intern, resident and attending - the latter 3 in the "Banyan fan and good friend" category. The most recent time, he brought a love interest, Luciana, who quickly became our love interest, also, she is that sweet and accepting of all of India.) The students have worked hard at doing physical exams on the patients, very thorough ones which I have not had the resources to do. We have picked up all manner of pathology and that is good for the patients, students and us. They also conducted a class for the health care workers and experienced the same joy I have, time after time - the interest from avid health care workers who want to learn and learn, and do, and heal, and cure. The session was good learning, and easily overran the time allotted.

The students finished up their time with an entertainment performance. This was to be in the nature of a fundraiser, but that was logistically infeasible during the holiday break, so, at Naren's suggestion, the students performed for the residents. And it was well worth the effort. They did a Texas line dance, and it was fun - replete with the performers in blue jeans and cowboy boots. The crowd loved the novelty of it, and the zeal and consideration of the students in performing for us, and the students had to do an encore. Naren and I danced to a new Tamil hit named "Kolaveri." It's a slow song, and not a pounding Bollywood number, but it was fun to dance with my son. He was the only man to perform, and a man dancing, of course, made the residents very happy. There was a finale, with many of the residents climbing up on stage and dancing, and Vandana and I watched Ms. E, the lady mentioned in my previous report: she danced in perfect rhythm, with pure joy and a wide smile, feeling the music and moving in perfect time - the trauma of her past as a sex worker all but forgotten, the core-rattling of her brother selling her into the profession submerged under wonderful, therapeutic music and dance. It was riveting and inspirational to watch her, and Vandana and I shared the same sentiment: what on earth do we complain for - that our bellies bulge and our pants don't fit and our skin is sallow. A look at Ms. E and all these concerns seem minuscule.

There is another patient who speaks English, and she shared her story with the students: one of drug use and drifting away from her family. There have been men and at least one child, and it appears that the drug use phase has passed, and Ms. T is ready to reconcile with her family. Her brother had come the other day and that I always find heavenly: our ladies crave family contact and said families usually don't contact. So we become the surrogate family, and try to do our best for the patients, and know for a fact that we would also, in addition to the residents, give a lot to have their families visit.

I forgot to mention that one of the gifts the students gave me is a framed photo of the 5 of us, outside the Banyan, all smiling and in Indian clothes and revelling in the pure joy that the Banyan is. It is a very nice picture, and is a good memento of the students' time here.

For New Year's Eve, a friend got us subsidised tickets to a party, and all 6 of us went. I danced practically from the time we got to the Boat Club, moving away only to rest my ears from the booming music. My friend's whole family was there, including his mother, who is a dear friend also, and we spent a very pleasant evening. The students mentioned having fun, too. Naren dropped all of us home and went to another party ('tis the age, is it not), then meeting up with his girlfriend. I had brought the lovely (inside and out) young lady a tank top from the U.S., and she told Naren she liked it; when I was shopping with Scott and had picked it out, he said, "You see, this is the difference between men and women. You buy her something sexy, I would have bought her a turtleneck." I laughed out loud at this - in the store and all the way to the car. Naren agreed with his father.

On New Year's Day, we visited some friends to seek their blessings and luxuriate in their affection, and had a most lovely visit. We also got together with the students for dinner at our house, and exit interviews, and that lasted 5 hours - full of chatter, their intelligence manifesting in wonderful ways, and laughter.

Let me end by wishing you a very happy and healthy New Year - 2012. May you get what you seek.

Unw -

R

2011-12-31T20:37:00.001-08:00

And this is why I became a physician.

We are back at the Banyan and it has been grand. 4 med students from my alma mater, the University of Texas Health Science Cent er at San Antonio, are working with us and they are a fun, idealistic bunch. Today, there is a cyclone (typhoon) afoot, with heavy rains and gusting winds, and all of us are staying put indoors.

Naren's computer won't let me access my blog site, and there is erratic Internet access from work, so let me email for now and I'll get my trusty husband to post this on the blog site.

Work has resumed in earnest. Every day, at the time we reach the B, there is a scheduled powercut. So, all 5 of us sit in the lobby from 8 to 9 AM, talking about various things and having patients come and sit with us and simply share the time. The other day, Ms. E, a new resident, joined us. She spoke of having been sold into the sex trade by her brothers when she was in the 8th grade, and having had 2 children, subsequently marrying; her husband committed suicide a year ago and she came to the Banyan. She gestured with her finger to the side of her forehead when asked why she came; we do not encourage labelling or derogatory gestures, and I asked that she simply address her ailment as a mental illness. She talked, and it appeared to benefit her to talk. She smiles widely daily, and greets us with great gusto, and I am impressed, again, that the human spirit can heal so well. I am grateful, again, to work in a place like the B, which would so enable torn spirits to mend.

You know, my brothers and I had wild spats growing up, but selling into the sex trade - aiya, no. As I mentioned at my most recent locum assignment, I do this work (with the destitute) for myself - that I return home and look at the four walls and roof of my apartment and feel grateful; that I hug my husband and sons and think that being able to see them is a big bonus; that I eat rice and egg curry and veges, topping it off with some yogurt, and tear into some sugarcane later, and think how fortunate I am that we can afford the food we like to eat.

The weeks in the U.S. were fine and the journey back was more aggravating than most times. Normally, I relax on the plane and watch movies and eat junk and sleep and gab away with the flight attendants; this time, I was irritated by every possible thing.

Christmas was spent in Chennai with available family gathering at my house. The med students joined us and that was fun. We went around the table, expressing appreciation for various things, and Naren waited for me to get teary. We read out a commendation to my father - he was awarded "Plastic Surgeon of the Year" by the Association of Plastic Surgeons of India - and since awards so float his boat, we re-celebrated. I missed my mother quite a bit, she would have loved the gathering and the food. The students had lovely gifts for me: a giant tin of cookies, which we opened in the evening, and a stocking full of very cool stuffers - tea, mints, candy, etc. I cooked much of the Christmas meal, making it a brunch and predominantly non-Indian food; that was fun. I would pay a lot of money for a salad right about now. We went out to eat a couple of days after Christmas, and that was nice; the owner of the restaurant stopped to chat and that was lovely. She is a good person, and we hugged in greeting; I rather like hugs, and find some physical contact therapeutic. Our head health care worker (hcw), Anjali, stated that her father was ill, and I held her arm and let her talk; he sounded terminally ill, and indeed, passed away the next day. Anjali is one of my favorite people, and I felt for her, that she was distressed at the prospect of losing her father. She will be back next week, and I will condole then.

Our cook and cleaning lady are well, and diversifying into various businesses. The cook has assured us that even when she becomes a millionaire (a very distinct possibility), she will not lose touch with us. This is our grand good fortune.

The students got to meet Vandana, and I am hopeful that they will meet Vaishnavi as well. That way, they can then see for themselves the phenomenal personae that set up this magnificent organisation, the Banyan, that helps all of us do our part to help those to whom life has dealt a rough hand. They also met some fine physicians at Sundaram Medical Foundation, the hospital that sees our patients for free; Drs. Arjun and Suresh gabbed with the students for a bit, and invited them to visit again.

Scott and Navin are well, and are in the U.S., celebrating Christmas and New Year. Naren and I are here. My sister, Anu, and her family are in the U.K. We were fortunate to see my father and sister-in-law and family in Chennai, and Christmas was a giant binge-fest. It continues to some extent, even now.

Unw (Until next week) -

R

Report of 14 Nov '11

2011-11-14T07:18:00.001-08:00

Wow, time flies -

In the last couple of weeks, I have been to Boston in my time off and then worked. Many from my high school now live in the U.S. and Nina hosted a mini-reunion at her beautiful house in Boston. Derrick came from Toronto and some friends joined us for dinner, and it was a merry time. Nina picked me up in a sporty Merc, and practically every cop at the airport was hitting on her :).

Work has been nice. One of our patients had his surgery cancelled as his heart started doing funny things on the operating table. He was understandably angry that his surgery had not been completed (regardless of the reason) and stayed snippy for a couple of days, scaring many of the staff. I, too, kept my visits short and one day, when I walked in there, he asked, "Is your last name Singh?" (Names of his docs were up on a board in his room.) I said, "No, I have a white last name, I'm married to a white guy," and the patient laughed and laughed. "Married to a white guy, ha ha ha." I told Scott later that there were indeed perks to be married to him, and this was the first time his last name had broken the ice with a very edgy patient. The patient and I then had a good visit, and he was discharged that day.

Nothing like laughter to make one's day, I tell you.

I was at the farm last week with 3 of my most favorite people: Scott's mother, aunt and uncle. We had a grand visit, with lots of laughter of our own, and I returned energized. I got to round with Dr. Love, and that was extremely rewarding - to soak up all that knowledge. Scott was on assignment in New Jersey, and returned last weekend, so we watched a bunch of movies and also attended the wedding of Carolyn Scanlan and Andrew Holmes, which was grand fun. We saw the Sparzos there - very good people, the kind you just sit and veg and talk and laugh with - and that was a double bonus. We also got to see Kris Rea and Gabe Soukup and their fun kids, and that, too, was salve for the soul.

I got to talk to my Dad and Naren, and that was nice. Navin might be home for Thanksgiving, and that will be nice, too.

Unw -

R

Report of 17 Oct 2011

2011-10-17T07:22:00.000-07:00

How time flies -

I meant to blog last week and ran out of time.

On Friday, 30 Sept, the 4 ladies coming to work with us at the Banyan - Neelima, Lisa, Andrea and Caroline - met at Linda Johnson's place with LJ, Deb Stedman and me for dinner. It was a nice, orienting kind of evening. These 4 students are grand fun to know - dynamic, intelligent, committed to making a difference. We look forward to their presence at the B. Dinner was a fun-filled, raucous event.

On 1 Oct, I got together with dear friend Aurora Freeman, our former neighbor in San Antonio. We ate non-stop (Aurora is a phenomenal cook) and just gabbed and laughed and loved, with the family. My grand-niece, Vayda, is a treat - just a little over a year old and with a joyous "Hi!" when she sees members of her family. Neelima and Andrea picked me up from there and dropped me at the airport, which I greatly appreciated.

Scott was here to get me, and we got home. I cooked a vat of food the next day and we had 30 people over that evening - colleagues and friends. Everyone was jammed into our tiny apartment ("Bring your own chair") like a fraternity party, and as a colleague said later, *had* to talk to each other. It is nice to interact socially with colleagues, lends a nice dimension to the work relationship.

Work has been nice; taking care of the truly sick is good. When they start talking about wanting prescriptions for their Percocet and Xanax, it is time to say, "I'll leave that to your family doctor, okay, we are treating you for cellulitis here."

We had an unfortunate gentleman with pulmonary fibrosis. It is a disease where the lungs get "fibrosed" and don't expand well. The only effective treatment is a lung transplant and this patient did not have any health insurance, either. He was discharged, and returned a couple of days later, with worse shortness of breath. He was put on a ventilator with little hope of recovery; his brave wife waited for their 2 sons to gather and then took him off the ventilator. He died shortly thereafter, at the age of 59. No age to die, really, but serious illness does not discriminate, does it now.

Navin came home for Fall Break and that was nice. I worked a night shift there, as the team was desperate for coverage. The family and I did manage to watch part of the ball games - it is nice to watch sports, which I miss in India. After that shift, we saw a bunch of movies in the theater, as I was fortunate to be off when Navin came home. We got together with my in-laws for Game Day, and that was riotous good fun - with everyone's senses of humor perked up for the occasion, and occasional bawdiness manifesting itself. We stopped by the farm to say Hi to Scott's aunt and uncle, and that was also very nice.

Naren is well; he had a theft of money from his closet at home and is rattled. All of us suspect someone close enough to be family, but she has never stolen from us before - that we know of. I phoned Naren and told him such lessons are priceless and trusting no one is a good adage to live by. Difficult, but good.

I am picking up another half-day shift today, so let me wind up. Hope all of you are well.

Unw -

R

Report of 30 Sept '11

2011-09-30T13:18:00.000-07:00

Hello from Texas!

I finished a lunch of very good Mexican food, and am hanging out at my old med school. If I stayed in one spot on my days off, I would likely be rested; however, being back at school is rejuvenating. I have had splendid, intellectually stimulating discussions with a variety of professors and students, partaken of fabulous food, met up with a very fun classmate - all good.

Work was fun, and being 7 days on did not seem as exhausting the 2nd time around. I still had my fair share of patients, including an older gentleman with myasthenia gravis who had had trouble breathing. His family brought him in to die and he recovered very nicely; I was delighted because the 80+ gentleman was full of wit and charm and all things classy. The family was puzzled and, in some cases, irate as they had been given a bad prognosis; I mentioned that I was actually delighted with the outcome. Even the family pastor asked after a fashion, at our initial meeting, when death would happen and I was a bit surprised at that. So the patient recovered well, we spoke of sending him to a different rehab facility and then he abruptly died. The terminal stages of myasthenia are unpredictable like that, I imagine. I was saddened, however, at the - to me - unexpected demise, but Scott said the patient had had comfort in his last days and that I should focus on that. This is why good spouses are nice to have.

A patient and his wife were on their way back to Des Moines from North Carolina and they stopped in Indy. At that point, the patient's pacer/defibrillator (a device placed in the heart which would shock it if it went out of rhythm) went off multiple times, knocking him to the ground. He was brought to the ICU and placed on a ventilator; when I saw him, he got a little unstable with his blood pressure and heart rhythm and we worked to stabilise him. The ICU team of nurses was magnificent and I was grateful for this excellent support. The patient recovered enough to be responsive, but regretfully, coded (got very critically ill) again in the evening. The cardiologist ran the code and it was futile, which the patient's cardiac nurse wife fully expected. She asked that we terminate the code, and the patient died. I could not leave the patient's bedside for a while, thinking we had not done enough. The wife's class and grace helped the situation immensely, and at the same time, made me feel doubly like a heel that I had not done enough.

So, I finished an exhausting week and boarded the plane for Texas. We were, unexpectedly, a little bit late getting to the airport, which I do not enjoy at all, and Security pulled me aside for a "random" security check. I ordinarily never mind this, but was annoyed this time. Random? I was the only dark-skinned traveller there, and after me, a similarly dark-haired traveller got chosen as well. Unabashed racial profiling, as happens apparently in all Israeli airports, would be refreshing honesty. Also set people up for refreshing lawsuits.

A bunch of us met at the home of Dorothy and Vick Williams (Vick is a former professor of anatomy) to celebrate the 60th b'day of Greg Freeman, former prof of cardiology. Sara Luduena (a former prof's daughter) and her friend Madeleine, med students Neelima, Lisa, Caroline and Andrea, Greg's secretary Elvia, and I met to greet Colleen and Greg Freeman as they walked in. It was a surprise party with Indian food, and Greg appeared to enjoy it. I was grateful to Dorothy and Vick for hosting.

I then went to the home of Linda and David Johnson; Linda is a professor of anatomy and Dave is a pediatrician. It is always therapeutic to be here, the Johnsons' perspective on life and their senses of humor are salve, and we talked for a while, greeting Dave who had returned from the grocery store with Therapia de San Antonio - Blue Bell Homemade Vanilla ice cream. I get spoiled here routinely.

The following day, I spoke to med students at an event hosted by the American Medical Women's Association (Amwa). The talk was about the Banyan, and the intrepid patients' stories spoke for themselves. I got a lot of questions after the talk, and am still fielding them as I sit in the library. One of the questions has provoked some soul-searching: what made you want to do philanthropic work? As Vandana and Vaishnavi have hastened to assure people who think they have sacrificed their lives to do this work, with the info that this is what V and V *want* to do, I too am doing what I *want* to do. Why? That's hard to say - because poverty should not limit access to care; because very good professors in a fine medical system taught me to treat the illness and not base treatment on the size of wallets; because I like the smiles of the impoverished when they realise they mean something to me.

I rounded with Greg Freeman yesterday and saw some cool cardiology cases. Greg is robustly enthusiastic about teaching and I always learn something new when I am here. He is also a funny guy, and we laugh quite a bit in the course of the day. In the evening, my classmate and friend, Katharina Hathaway, made the trip from Austin to have dinner with me and that was a blast. Katharina does a lot of work with refugees, including those from Myanmar and Bhutan - definitely countries from my neck of the woods - and we had a good time talking of it. She has done some going-the-extra-mile work with ensuring access to care for this marginalised populace, and appears to love what she does; I can fairly guarantee that her patient populace is grateful.

Today, I went to pediatric Grand Rounds with Dave Johnson and appreciated the chatter on the way up. I stopped by the office of Alumni Relations and saw Sonia Rogers and David Perryman, fine folks there. We had a good time catching up with their work and family lives; they are efficient, personable and nice people. Today, I have also met separately with Dorothy and Vick Williams, on issues of faith, and have thoroughly enjoyed the extraordinarily intelligent viewpoints from a couple of deep thinkers. I will always be grateful to the Williamses for indulging me.

The 4 med students mentioned above are coming in December 2011 to work with us at the Banyan, and we will meet for dinner tonight at the Johnsons' to discuss that. The planned dessert: brownies and Blue Bell Homemade Vanilla.

Last week, Scott turned 50 and we ate at a very lovely restaurant recommended by a nice colleague. The service was very good, Scott got a free dessert, the food was very well-made, and the evening was memorable. On my request, Scott wore his new suit to dinner and looked very dapper. On our way out, it started raining and that is a very auspicious sign by Indian standards - likely based on the fact that we used to be a predominantly agricultural society, but I'll take the good fortune.

Calling home will have to be done this weekend, and I look forward to it. Both our sons are well, thank goodness, and Scott and I are slowly getting used to the fact that both young men are now out of the house, living their lives.

Unw -

R

Report of 19 Sept 2011

2011-09-19T07:15:00.000-07:00

Hello from Greenwood, Indiana -

I have a few days off from work, and the socialising has been as exhausting as the working - in a different way, of course. My work shifts are 7 days at a time, 7 AM to 7 PM, and the days are long. Hospital medicine is good, though - the patients are truly sick. In outpatient settings, they could come in for anything. Or come in for 1 thing and mention 4 to me when I got in the room. Certainly, complications can set in, in our hospitalised patients, but there are some that one can anticipate.

The lack of the weekend takes a bit of adjusting, but days off include weekdays and those are nice. So, after working 7 days, I get 7 days off. And a weekend certainly does feature there, which is nice because Scott does not work then and we go off and do fun things.

The patient who used to be an IV drug user was re-hospitalised with a kidney infection and this time, she had an upset stomach, too. When one takes antibiotics, they can cause diarrhea, and that is indeed what she had: Clostridium difficile colitis, and I treated her for it. She was doing better by the time my shift ended, and we spoke of things such as her return to school. She would like to do behavioral science or psychology, and be a substance abuse counsellor. This is good. As she put it, "I would like to tell folks who think their situation is hopeless and they have to do drugs and there is no other way, that there IS another way. And I found it." Some of the best substance abuse counsellors are those who have recovered from it themselves.

There was another older patient who needed her gall bladder taken out. She was extraordinarily sweet and all - nurses, doctors, techs - loved taking care of her. I tell you, there truly is some truth to the adage "You can catch more flies with honey than with vinegar." I don't particularly like the fly analogy, but it was a great pleasure taking care of this patient. One day, her pretty grand nieces visited along with the fiance of one of them, and my patient had a very good visit. It is extremely therapeutic - usually - to see family.

Speaking of which, I talked to my Dad last week. He had received the "Plastic Surgeon of the Year" award from the Association of Plastic Surgeons of India, and was pleased. I was happy for him that he had got this award and we talked at length of it, and other things. Awards certainly float his boat: to each their own. I also talked to Naren, who just finished a small movie role! We talked and laughed about it, and it was good to hear him.

Some of Scott's relatives, including a beloved aunt and uncle, and his sister, joined several fabulous friends last weekend to celebrate his 50th b'day. A grand time was had by all, including the b'day man. A couple of our college friends, Cathy and Mike Monteiro, also came up for the party and that was therapeutic - to talk of old times, compare kid notes, parent notes (all of us are at the age where taking care of parents features in conversation), etc. The Tabers, Olivia, and Carolyn Scanlan and boyfriend, Andrew, rounded up a very nice gathering. Olivia spent part of the weekend with us and that was nice.

Before Navin left for school, we had visited Theresa Jefferson, who is an exceedingly lovely lady, and I was happy that he had been blessed by her. We had seen Kris Rea and Gabe Soukup (Navin's boss) and daughters as well, and that was like getting together with family; Navin particularly appreciated their kindness.

I met some former colleagues at Elwood and Alexandria and we had lunch, which was great fun. Some former colleagues at St. V and I got together for lunch with the former manager of Medical Education, Jim Hillman, and his wife, Brenda, and that was nice. Navin came up from college for Scott's party, and it was great to see him; his hair is wild and woolly and he is figuring out his way at college - it was challenging not to direct operations wtih this young man, and to take a back seat and let him do his thing, with his education. Our wonderful extended family - Colleen, Mark and Christopher Taber - took Navin back to school, and Christopher to Indiana State University, also in Terre Haute. Scott and I then saw "Contagion," courtesy a gift certificate from Olivia. I had earlier seen "The Guard," which was truly magnificent and "Crazy, Stupid Love," which was very good because I could easily get an eyeful of Ryan Gosling.

Time to wind up. Hope all are well.

Unw -

R

Report of 6 September 2011

2011-09-06T08:21:00.000-07:00

Hello from Greenwood, Indiana -

It has been several weeks (5!) since I blogged and I have missed it. Blogging is a tad complicated by the fact that apparently a relative uses it to keep up with the whereabouts of the spouse and they then get into huge fights. This is bothersome and has taken away my love of writing, but this love is slowly returning. I have never seen a point to fighting or to snooping around, checking cell phones and messages, etc., for people's activities. One of my aunts has called it "cracked." To each their own, I imagine; it is nice that neither Scott nor I has to resort to alternate means to locate each other.

We left India on 8 August and spent 2 grand weeks at the home of my residency classmate and rheumatologist, Kris Rea, and her husband, Gabe Soukup. These are some of my favorite folks and Gabe owns a franchise of "2 men and a truck." Both K and G have battled some tough times, and have cores of steel and hearts of gold, and I wanted Navin to work with Gabe. Gabe promised no favoritism, which I welcomed, and Navin passed the movers' test and started working. He worked with some tough young men, including those who had once been incarcerated (he liked that Gabe gave them a 2nd chance), and learnt some invaluable life lessons. He wisely kept his mouth shut during arguments - a skill his mother is yet to learn - and earned some good money. I took him out for lunch one day at "Applebee's" and he looked at the menu and said, "This is so expensive." I liked it. He is paying for himself now, and knows the value of cash. K and G's young daughters, Isabella, Rosalia and Gabriella, were their usual loving selves, and Navin and I had a great time there.

We did visit the farm and catch up with relatives, including ailing ones. It was nice to sit outside and shoot the breeze with folks.

Scott came on the 25th, after I got teary on the phone with him. Navin and I had been at McDonald's, and some very scantily clad young women came by, then sprawled sexily on the Ronald McDonald figure to take photos. This was core-rattling - the culture or abject lack of it - and I requested Scott's presence. The nice thing is that Scott is set up to work from here and that has been therapeutic. We took Navin down to Rose-Hulman, enjoyed the orientation and magnificent speech by the president; among listing the students' achievements, these words: "You may be gay, you may be straight, you may not know. Differences are not a threat here, they are learning opportunities. We are Rose-Hulman." I was thoroughly impressed. There were upper-class students available to carry incoming students' things into their dorms, and I thought that was a nice touch. Navin beamed from ear to ear when meeting his chair and his advisor, and seemed happier than we have ever seen him. The welcome at R-H was palpable and we left feeling that Navin was in a great school, and I with a lot of relief that Scott was alongside.

I oriented at Community Hospital South, and started work last week. It is fabulous. I have not done hospitalist medicine before, i.e., taken care of inpatients. It is grand fun, though. It is nice to take care of the truly sick. As I left the room of a young (21 yo, not much older than my sons) ex-heroine addict who was admitted for a serious kidney infection, I heard a faint "Thank you, Dr. Weiss," and she had my heart rightaway. How fortunate are we who have robust family support, loving and guiding, so that we did not have to resort to intravenous substances for our joys.

Naren is well and enjoying his solo time in our apartment in Chennai. He is 20 and sensible, and so we have not had to lay down ground rules for him. He went over and wished a beloved neighbor on his b'day, and our friend's wife emailed and told me how kind that was.

We had a bunch of my colleagues over for dinner and it was a blast. We have also caught up with the entire Taber family - who are our home away from home. I love both Taber kids - Melinda and Christopher - dearly. We have also seen the Sparzos, Carolyn Scanlan, Mary Remster and Shilpa Mallur and their families. All lovely people, all dear to us, all wanting the best for Navin (and indeed, the entire Weiss family), all part of the support that ensures joy from their being and not through IV.

Unw -

R

Report of 2 August 2011

2011-08-01T20:35:00.000-07:00

Hello from the Banyan -

Yeesh, it has been 2 weeks since i blogged and I have missed it.

The Banyan has been fine. I am trying to finish up some work before I head off. Classes have gone on very well, and it has been grand to teach the young women and watch them learn and grow.

There is a patient in the sick room, there with leptospirosis. She is of the highest caste, Brahmin, not that that matters a can of beans to me. It does to some. Her brother has apparently left her here and gone away, never to return, never to visit. She asks about him regularly, wanting to see him, and I asked the social worker if we could contact the family. He said she had "failed rehab," which means the family had been contacted but had refused to accept the patient back. I was stricken; what do I tell her now? I asked the social worker if we could at least suggest telephone contact to the family: this is an uphill battle, but let's give it a go.

If I could not see my family whenever I wanted, I would not be a happy camper.

Speaking of family, Navin and I did the rounds of relatives, seeking blessings before he leaves. Coorg was nice, and we saw beloved aunts and cousins. As I walked into my cousin Dhanu's house, there was the strong smell of jackfruit, which I had requested. Dhanu then cut a huge guava, and salted it; it was tasty. He is younger than I, but given to spoiling. We had a nice time there, saw other cousins and headed onto Mysore to see my mother's 3 sisters. We had lunch with them, and saw more cousins, then got on the very comfortable train to head back to Chennai.

We saw the finals of Naren's play competition, and their play won "Judges' choice - Best play." We were pleased. Scott headed off to Trivandrum, the boys and I spent a week by ourselves and then went to Patna, the capital of Bihar. We met our neighbor Pushkala's friend, Medha, there; Medha is doing some magnificent work in the prevention of trafficking of young women. (Bihar is on the route from Nepal.) I am certain that we will collaborate in the medical arena before too long, and look forward to it. Our very nice taxi driver there, Medha's contact, came with us to Bodhgaya, where Buddha attained enlightenment. The spectacular temple there is maintained with the help of several countries' governments, such as Japan. The sight of the giant Buddha statue was very soothing, and Navin too states that Buddhism is the religion that has made the most sense to him.

We are back now and counting down before we head off to the U.S. Navin spent a couple of days in Madurai with his grandfather, finishing up his medical checkup, etc. I spoke to my Dad yesterday and he said that the 2 of them sat in the doctor's waiting room in total silence; it was pretty funny. Our cook in Madurai, Ms. A, has had a baby girl; she called me yesterday with the news and all of us are delighted! Ms. A has had a very rough life; now that she is happily married and a mother, some normalcy is returning to that life. Hooray!

Unw -

R

Report of 19 July 2011

2011-07-18T20:41:00.000-07:00

Hello from the land of sunshine -

This is what it's like to parent teenagers and work and run a household and, and. Not as though I am the only person in the world doing this. This morning, the boys' room had the fan blowing on full without anyone in it (a giant waste of electricity) and when the younger boy came out of his shower acknowledging blame for this, there were 7 pieces of clothing in the bathroom. 7. Argh - I have told this chap before of the very same issues, and so a hefty financial penalty ensued. He even has to go to the bank to get the rest of the fine.

Time with both boys is otherwise wonderful - they are fun and funny and kind.

The Banyan has been good. I had a giant learning experience the other day. We have a non-Indian patient with a gender identity disorder: she looks female, but the male social worker suspected that she was male, and the senior coordinator asked that I examine the patient. The patient is floridly mentally ill, and refused to lie down. So the exam was done standing up. First mistake, said my father. The patient convinced me that his/her male genitalia had been offered to God, and there were no breasts, so I pronounced him male. A couple of days later, Leela, our able nurse, said the patient had been sent for an ultrasound and a uterus had been detected. Double argh. My father and I had a detailed discussion about this, and he is an expert at sex reassignment surgeries. It was an excellent learning experience, especially as I embark to the U.S. for a work assignment.

The week was fine. Naren was in a play for a competition. 10 ten-minute plays were staged last week and the best 5 are through to the finals; Naren's is one of them, and the director got "Best Director." She is an extraordinarily talented young person (maybe 22 years old), and we are pleased. 10 different plays will be staged this week and Naren is in one of those as well. Navin is usually delighted to show his support.

My father was up here, on our invite, to see the plays and to spend the weekend with us. This is not normally his cup of tea, he prefers lightning visits. But he agreed to come, and we hung out, saw the rest of the family at one meal. Then went to the plays, which were good. We also had a bunch of neighbors and friends over, and our old friends, Joan and Mohanraj, were kind enough to join us. It was a marvellous evening, full of bonhomie and good feelings.

Nothing like being in touch with the family, I assure you. Absolutely nothing in my world justifies fights and prolonged silences. It is nice to see each other, revel in each others' senses of humor, and have our children influenced by the goodness in our relatives.

Unw -

R

Report of 12 July '11

2011-07-12T04:43:00.000-07:00

Hello from my living room -

There is a new kind of exhaustion: quite a bit due to sleep deprivation (for some reason, I could not get back to sleep last night after awakening at 12.30), and also a fulfilled kind, because I had a good day at the B.

Our patient with the possible seizures was evaluated, the neurologist agreed with the seizure diagnosis, and meds were started. Ms. P has fallen in the past and clonged her head, and there is a blood clot (a "hematoma") seen on the CT scan. This can cause some dizziness, etc., and I want neurosurgery to see if the hematoma needs to be removed ("evacuated"). I feel privileged to be able to take care of folks who have no others - and no money.

One of our older patients looks ill. It is patent on her face, and I asked for a heap of blood tests for Ms. V. The sodium came back very low, and I have asked for water to be restricted so that the sodium can creep back up. This is the joy of being an internist - that a blood test or two can tell you what a patient cannot. I had also thought Ms. V might have leptospirosis or malaria, but thankfully, she does not.

One of the ladies who cleans our apartment complex came to me, stating that her sister had not become pregnant six months after marriage, and people "were saying things." If a young woman does not deliver a baby nine months after nuptials, people "say things," and it is always the woman's fault. I asked for the lady to be evaluated at the local Public Health Center, but it has not been done as the mother-in-law does not approve. Right, then; our employee came quickly back to tell me and said, "I wanted to tell you because you'll shout otherwise." Correct; when this lady (our employee) had had belly pain and I was terrified that she had adhesions from her prior C-sections, she did not get evaluated as I'd suggested and I'd shouted at her, saying, "Who am I - just the doctor, right. You go ahead and do what you think is best." So she'd come back hurriedly to tell me her sister's update, and I appreciated it, telling her that we ought to wait for in-law businesses to settle. A little ire is sometimes justified, to me.

Mr. Vellodi, the senior trustee of the Banyan, turns 90 soon and the Banyan celebrated the grand occasion last Friday. It was a blast - plenty of bonhomie and camaraderie and enjoying each other' talents. Navin and I danced to a pulse-pounding Tamil song (Naaku Mukka), and it is on You Tube. We had not announced earlier that we were dancing, and the staff were surprised to see the physician jigging on stage. It was fun to dance with my son. My other son - just as good a dancer as this one - was rehearsing for a play and could not join us. There were plenty of other dances, too, and a cake was cut as well. All in all, a very fun and rejuvenating time.

Scott and I spent the weekend in Madurai with my father - talk about a fun and rejuvenating time. We ate, talked and laughed, and Scott and my Dad watched a little TV (I am not at all a fan, so did some work sitting in the same room as the men). Scott's gentle presence is very welcome to my Dad, and we spend a fair amount of time simply sitting and gabbing (and eating non-stop!). We also saw my friend, Tanya, celebrating her 50th birthday with her, and Mrs. Kurien, who did us the grand favor of examining my Dad's cook, who is pregnant and scared to go for checkups. It was nice to see both Tanya and Mrs. Kurien.

Unw -

R

Report of 5 July 2011

2011-07-04T20:33:00.000-07:00

Hello from the B!

This is part of the joy of working here. One of the residents, Ms. P, now treated effectively for her mental illness and working in a beauty parlor, came up and mentioned that she was doing well. She had burst into tears at our last meeting, saying she was upset that folks were yelling at her. I had held her hand, told her to kindly ignore yells and gossip, and told her that we were all there for her; one of the other senior staff had apparently extended some special assistance with getting the psychiatrist to see her and she was grateful. She said even her mother would not take such good care of her. Ms. P is a young lady, with her whole life ahead of her, and with the mental illness nipped, I am watching her blossom and succeed. All joys. One of Bollywood's leading actresses had employed her once as a nanny, and Ms. P had flown to Mumbai (generating quite some envy - airplane rides are not de rigeur for our populace); however, she had not enjoyed her new environs or job at all, and came back. We are, indeed, quite happy to have her back. Whatever works best for her.

There is a new permanent occupant of the sick room. Ms. X has been falling often, and we need to make sure bones don't break. Every time she sees me, she speaks of her father, mother and brothers, mentioning them by name; I get near tears when this happens, because there is little chance that she will get to see them. She says she does not want a second marriage. When I looked at her file, I saw that she was rescued from the street, abandoned by her husband. With lack of family nearby or claiming her, and with the lot that befalls many women here, there is likely no attempt on anyone's part at a second marriage; this also saddens me, because Ms. X talks of it with some gusto. Certainly she states that she does not want it, but it sounds like a harking for something a tad happier - a nice husband, children, a life elsewhere. And this saddens me immensely. The Banyan is, consequently, a haven for me: that such ladies are accommodated and taken care of, so that even if their dreams elsewhere are indisputably shattered, we can attempt to rebuild their spirits and bodies.

Ms. X had had what I thought were seizure symptoms and we'd sent her for a neurological evaluation at the teaching hospital nearby; they usually do a very good job with our patients, and for free. I was not content with the subsequent diagnosis of vertigo, so sent a detailed letter to the neuro service, signing it with all my credentials. It looked like alphabet soup after my name. I usually avoid this, unless I want some extra care for our patients; then the MD (USA), AB, works wonders.

Scott and I had a day beyond amazing on Sunday. Neither boy was home, spending the night with friends, and we got up languidly, with no pressure to make breakfast or, indeed, do anything. I got a bunch of chores done, and then Scott, who was reeling under allergy symptoms, got up; we read the paper, had a nice meal, I talked to my father and sister-in-law, and then Scott and I managed to catch up on this and that. Scott is a phenomenally intelligent individual, with a very sharp wit, and a great love of India; all these make him wonderful company. We also got to play a game of euchre, a fun activity b.c. (before children), and it was a nice, relaxed, rejuvenating time. It was quite awesome. We had had giant issues off and on - with raising kids, the troubles that they routinely got into, the intense arguments that would ensue when 3 opinionated people went at it (Scott being the only placid person there) - and the fun in our lives had been a tad buried. Thankfully, buried in a shallow pit from whence it was easy to haul back out. I tell you, the day was more therapeutic than any other course of action we've been through.

My friend, Greg Brown, told me that his shenanigans as a teenager nearly caused his parents to divorce, and I imagine the stress of raising teenagers manifests at odd times. Or "all" times.

So the next morning, as both boys, of course, were their usual selves - milk mug not washed, dawdling over breakfast - I did a little dance and said, "In two months, this won't be our problem any more." In 2 months, both boys will be away at college, Insha Allah. Both boys were surprised, and Navin said, "Amma, you're not supposed to be happy at this." And then, when the jig continued, "I know you're just trying to cover up your grief." I laughed out loud, and when I mentioned the comment to Scott, his laughter matched mine.

We saw "The Green Lantern," and in my new Love Everything mode, enjoyed it. I especially like the supporting players in such movies, and thought Peter Sarsgaard did a great job. Way down in Australia, we caught the first X-Men movie, and old Michael Fassbender came through again. Naren just has to mention his name for my salivary glands to get into overdrive.

Right then, I'd better wind up.

Unw -

R

Report of 26 June 2011

2011-06-26T06:43:00.000-07:00

Hello from our living room -

My very intelligent husband is here reading the paper, one son is at the gym, the other is at a puja (Hindu worship ceremony); we have many sweet and luscious mangoes in our fridge, and life is good.

We think of our Australian holiday with great nostalgia, and Naren has admired the public transport system in Sydney. Scott, with his usual meticulous attention to detail, figured out which bus and train we needed to get to our destination and we boarded accordingly. I am not a big one for reading things; our neighbor in San Antonio, Aurora Freeman, used to quote her teacher saying, "When all else fails, read the directions," and Scott does that splendidly.

I went back to work this week and it has been magnificent. My friend, Emily McNellis, has darling twins who contributed to sending the B a giant bag of candy and it has been extremely well-received. My friend, Tiffany Anthony, whom I was fortunate to catch online just now, sent along some clothes for the B and a couple of bottles of perfume for me; I gave the perfume to the 2 senior health care workers (hcw's) at the B, who work their hearts out for the B and for me, and they were delighted. "Foreign" gifts are always giant treats. All the hcw's and I met and talked, and I have an idea how things are going with them. This is extremely important to me. At the 2nd meeting, I took some laddus (somewhat expensive Indian sweets) and at the end of the meeting, I reached into my bag; on hearing the rustle of plastic paper, there were murmurs of "Chocolate!," and Anjali, one of the two senior hcw's, quickly changed her position and came charging to take a seat near the front. It was very funny. I adore these young ladies, and we share many occasions together. When my mother was ill, there were organised prayers from the B - coordinated by the then-senior coordinator, Vanitha. I greatly appreciated this.

The B's patients are well. A couple of long-standing patients have died in my absence and I miss them. We also no longer have a physical therapist, so gait training for our weak and frail patients is languishing. If they fall, they sustain a fracture as nearly all have brittle bones; so, it is to everyone's benefit if these folks can maintain a steady gait. One of the younger patients is a pharmacy student and she came by to say Hi to me; I like the fact that this young woman is studying and I asked how things were going. She's got 3 papers left to finish in August, and then she's a pharmacist. Her family life is not ideal, with her father and stepmother not wanting her home; no worries, she can be with us! I am waiting for the day when she passes and gets her degree.

The cosmos righted itself when I got to the B. It is a magnificent place to work. Our very capable nurse, Leela, had a gift for me - some fabric to make a salwar kameez (the loose pants and tunic that many of us wear) - and that was lovely. We had attended Leela's son's baptism and had a grand time.

We also had a giant surprise party for Navin's 18th b'day (he almost had to pick his jaw off the ground when he saw his 30+ friends) and attended the wedding of the brother of one of Naren's close friends, KK. I love the fact that we (Scott and I) are considered friends as well, and the boys and I danced my heart out (the boys were not really in a dance-y mood but obliged me); my salsa lessons failed me when KK and I danced, but he was gracious. Anu, my sister, stopped by on Sunday morning, en route back to Vellore from Delhi; Anu is a hot-shot researcher and is in trials with a lot of people, some supported by the Gates Foundation. It was good to see her and we (Weisses) were up to our elbows making pasta salad, but stopped enough to chat. I spoke to my father, and he was frightfully busy, which is good. Today, our whole family caught a movie (made by Vandana's husband Senthil's business partner) and then we came home to clear out a fridge full of leftovers. I had made the usual dreadful chocolate pudding, which the men ate with gusto. I do wonder at their palates. We discussed the movie at length; I love listening to the men's opinions. I do believe it is because we don't have a TV that we have raised thinking, discerning children. Having said that, I so miss watching sports.

Today's Scott's Mom's b'day and Scott has phoned and wished her. My mother-in-law is a good and fun person, with a solid sense of perspective and giant sense of humor, and I feel very privileged to be a part of that family. Unfailingly, my mother-in-law puts her own wants behind those of her children, and I am continually impressed by that.

It's a good life. Good work, nice family, loving extended family, fabulous friends.

Unw -

R

Report of 19 June 2011

2011-06-19T01:30:00.000-07:00

Happy Father's Day!

It's not a holiday celebrated in India, so Scott had to settle for verbal wishes and no gifts. In a prior life, the boys would have scrounged something up from our pantry (cookies or candy), wrapped it and handed it over, but the young men are now grown.

We are back from Sydney and had a spectacular time there. It was winter, and all of Sydney was apologetic for it, but I love the cold and we had left 100 degree heat here, so to loaf (roam) about in cold weather was great. We normally wander frenetically from 1 place to another (we did 8-9 countries in Europe in 14 days), but this time chose to stay put in Sydney and are glad we did. Andrew Penman booked our lovely accommodation and we cooked Indian food at his house, choosing this option over taking him out to eat. His wife, Rosemary, was in New Zealand, had to stay longer due to the volcanic ash and we were sorry to have missed her; his daughter, Meredith, joined us and that was grand fun. Meredith is a stage actress and she and Naren had a lot to talk about. All of us laughed a lot through dinner - everyone at the table being wonderfully opinionated - and that evening was memorable. Andrew speaks fluent Hindi and I do not.

The Centre, the bed and breakfast we stayed at, was well-connected to public transportation. The staff were, to a person, lovely and helpful. This added to our fine time there. The beaches of Sydney were not novel to us, as we live on the coast, but there were some fine sights to see. And scenic walks. And plenty of good food and chocolate to gorge on.

It was also great to see Kalpana (nicknamed Bugs), my friend from college days (over 30 years!), and her husband, Suresh. We spent a day with them, and cooked and talked and laughed. There is something singularly therapeutic about being with friends from long ago - a certain familiarity that has one saying things like, "Okay, we are taking the rest of this food back to the B and B," and "Can I raid your sambar powder as we are cooking a meal for some friends?" We went to a lovely park near their house where we got to pet koalas and kangaroos, and the boys will remember that for life. Bugs handed the boys a generous amount of cash - as close relatives will - and the boys bought some special treats with that. I think that, too, will be remembered :).

We are back, safe and sound. The service on Qantas was dreadful and even simple requests - a snack, a soft drink - appeared to be insurmountable obstacles. When Naren, in his newly-found adult role, and I complained to the in-flight supervisor, the man got irate, blaming Qantas management for the flight being understaffed. There are various ways of handling feedback, are there not. There are also repercussions to being understaffed.

We talked to my Dad yesterday - checking in - and he is well. He was in Kanyakumari, inaugurating a conference on Maxillofacial surgery and having a great time. I am glad he is active and gets about. He is inaugurating something else today, in Madurai.

I will be back at the Banyan on Tuesday and look forward to it.

Unw -

R

Report of 13 June 2011

2011-06-12T17:32:00.000-07:00

Hello from Sydney, Australia -

We are on holiday here and Dr. Andrew Penman, a member of the American College of Physicians and the CEO of the New South Wales Cancer Centre has found us a wonderful bed and breakfast here. We have seen old friends, Kalpana and Suresh Rao, spending a spectacular day with them; seen the Sydney Opera House and the Talonga Zoo; and met Andrew and his daughter, Meredith, for a very lovely dinner last night. Both Andrew and Meredith are firm fans of reaching out to the marginalised, Meredith as a stage actress and Andrew in his role.

Medicine has taken a bit of a backseat, except for treating the men off and on. Australia is nice, it is winter here and everyone is apologetic about the cold and wet weather. However, we left 100 degree heat and 80% humidity and no airconditioning, and I have run the last 3 mornings here, marvelling at the fact that I am not sucking wind 45 seconds into the run. It has been lovely and cold.

More after we return to Chennai -

R

Report of 6 June 2011

2011-06-05T22:54:00.000-07:00

Hello from exhaustion -

A couple of late nights in a row - would not have fazed me 20 years ago - and I am distinctly fatigued and feeling unwell this morning. Yeesh.

Our fun patient, Ms. M, has died. She was the one who always used to ask about my husband and if he was still with me. Her own husband had left her and the Banyan had gone after him to pay her a monthly allowance. He did, and Ms. M was one of the wealthiest at the B, many getting no money at all from families that abandon them. Ms. M was diabetic, and I have to guess at her cause of death, as a post-mortem is not a viable option for our patients. Not for the expense, but because the request for a post-mortem has to cast blame on someone (either at the hospital or at the Banyan) - which entails the police landing, demanding a bribe, etc.

As always, I am grateful that Ms. M died surrounded by people that loved her and cared for her, instead of on the streets. Hema, our intrepid person in charge of Friends of the Banyan, U.S.A., had sent Ms. M a big sheet of stickers and Ms. M was thrilled! She told me the sheet was the size of a big photograph and was very pleased; the stickers are now stuck on the walls of the sick room, including the wall near Ms. M's bed, and sure do brighten up the place. Thank you, Hema, for making our day and that of one of our patients.

We were in Madurai last week to see my Dad and that was lovely. My Dad and I have long, philosophical talks about all matters, and also chats about the profession. The cook at my parents' house, Ms. A, is expecting a baby in August and the bangle ceremony had taken place some days prior at her in-laws' place. This is a ceremony where many glasa bangles are placed on the expectant mother's arms - for many purposes, such as that the other occupants of the house are alerted by the jingle of the bangles that the expectant mother is approaching (so no one barges into her) and so that the baby hears music. After this ceremony, the young wife is taken to her parents' house so that she gets to rest a bit (away from the chores of the in-laws' house) and nourishes herself prior to delivery. My father had brought Ms. A back, and she was pleased; I told her our house was indeed her house as well, and that I was glad her ceremonies had gone well. She brought me her ultrasound report, and I assured her and her husband that all was well; it is nice to have the knowledge to read and interpret such reports. Ms. A asked if the ultrasound showed the gender of her baby; it cannot, by law, and those tell-tale pictures are removed to attempt to thwart the practice of female foeticide.

We were at a friend's brother's wedding yesterday and that was fun. KK is actually Naren's friend, but he is now a friend of the whole family. My salsa knowledge has faded almost totally and I could not get my rhythm when KK kindly obliged me to dance. So embarrassing. The Weiss men did not want to dance, but Naren also kindly danced with me when I wanted to dance to "La Bamba," and such.

We will take a short holiday starting tomorrow and then I will return to work on 20 June.

Unw -

R

Report of 3 June 2011

2011-06-03T00:37:00.000-07:00

Hello from our breezy living room!

It has been a busy couple of weeks - watching Navin row in the regatta and win a couple of prizes; attending a wonderful family wedding in Bangalore; hearing Navin sing at a concert organised by his voice teachers; celebrating a couple of family b'days; seeing Naren in a play. Medicine has been interspersed with these occasions.

The wedding in Bangalore was of my mother's cousin's daughter. My mother was of the "Pattada" family, and so is this cousin. So the Pattadas were out in force and it was great to see everyone. We stayed with my sister-in-law, Susan, and that was merry: sleeping bags and a late morning, plenty of fruit and being taken out to eat by Susan. She has received a big promotion at work and is in charge of a prestigious project for Johnson and Johnson, so the meal was a grand celebration. My father was with us, also, and that was fun; it was nice for all the cousins (our kids and their ilk) to meet at the wedding and subsequently one faction to continue the fun at lunch the next day. I tremendously appreciate the chance to be in touch with family.

Navin's regatta was fun and he rowed well; I love the chance to see our sons perform - on the sports field or on stage. His concert was also nice. Yesterday, we saw Naren in a play called "The word of God," and he was good, as was the whole cast. We will see it again 2 more times. Birthday celebrations with family were at local restaurants and those were grand fun, with available sibs and nephews and spouse and kids.

On return to Chennai, my cousin Sheila phoned. I had to treat her for a small medical issue, and then we discussed what they were doing for their maid's child. The little one has a hole in her heart, and Sheila and her husband, Sunil, have run around getting all the paperwork necessary for the child to have free surgery under a Government scheme. We will know the outcome (about the funds being sanctioned) next week and hope for the best. I commended Sheila for the wonderful interest she was taking in the child's case. Truly, there is something so rewarding about doing for the poor. Sheila is a dear, and though our parents (my mother and her father) did not talk to each other, I appreciate the fact that the cousins have kept in touch.

Where would be without family, and close friends.

Unw -

R

Report of 17 May 2011

2011-05-17T03:12:00.001-07:00

Well, we breathe again -

Navin's school exam results just came and he has done fairly well. He was tutored by many devoted individuals, including 2 young women just about his age, and they extracted - like teeth - good performances from him. 1 subject (chem) was a bit of a let-down, but now he knows how to study it.

We have been well and will get set to send this kid off to Rose-Hulman. Naren is busy with his internship at a local TV station and enjoying it. The good thing is that they let him do some work, instead of having him sit in a room - for the duration of the internship period - with a training manual.

The practice of medicine continues, with stray cases here and there. The gardener lady in our complex appears to be doing well with Ibuprofen, and one of her colleagues approached me for help with her sister's health. This is de rigeur for me, having to refer or see patients sometimes without seeing them. But that is the way it is with the impoverished here, and we must do the best we can. Always, always a privilege to use my education for the benefit of those whose next meal is never a certainty. Dr. Love and Olivia graciously donated a few medical journals to me and I have been reading some of them; always a joy to read a well-written article.

We attended our able Banyan nurse Leela's son's baptism. His name is similar to our son's: Naveen Mathew. (Ours is Navin Matthew and they sound exact.) Leela's brother is his little nephew's godfather, and I am delighted to see further manifestations of Leela's reconciliation with her brother. Nothing like getting along with family.

Speaking of which, we will be at a family wedding in Bangalore this weekend. It's my mother's cousin's daughter and the father (said cousin) has been magnificent about phoning everyone and inviting them personally. So we'll go and eat and dance and enjoy family, especially those that would warmly invite us. Naren and Navin are always delighted to meet cousins they haven't met before, and are uniformly happy when these cousins are not just nice, but "hot." :)

Unw -

R

Report of 27 March 2011

2011-03-27T04:27:00.000-07:00

Hello from our living room -

And the exams are over. The tutors have done their jobs, one boy has studied, taken the exams and finished them, and is now breathing easy. Many of his friends have not finished yet - those taking the sciences ostensibly finished first - so the party is not hearty, but some partying has started.

Breakfast this morning was from 9.30 AM to 12 PM. I love, *love* these times: the boys are intensely opinionated and insightful, Scott is funny, and we discuss all manner of topics with candor and considerable laughter. Naren's perspective is very gentle and spot on, and he tends to be able to deal with Navin much better than any of us can, so there was a fair amount of advising on college today. Navin took it very well, and that is really how Naren intended it: not to be preachy or judgemental, but just his opinion and advice. As the boys go into adulthood, it is nice to watch them interact; so we eat chocolate and junk and dreadful pudding and fruit and eggs, and talk and laugh until other things intrude on the schedule.

The Banyan has been fine, and I am getting enquiries about when I'll return. Navin now has entrance exams to write, and I have a superlative conference to get to. So off I go. However, the Banyan's pull is very great and this is a lifelong association. One of the health care workers (hcw's) has had a baby, and we are happy all are healthy. The hcw's are big reasons for my working at the B. Another hcw supervisor told me of her children's wonderful grades, and I was very happy to hear that: education truly is the way out of poverty.

I think of Ms. G, one of the patients at the B, and her cancer, and her peaceful passing. The social workers had tried desperately to find her family, without success. And then, in front of my eyes, she started to look skeletal, and we found the cancer. I will always be grateful that our patients have the warm, loving surroundings of the Banyan, in life and, most importantly, in death. I shudder at the prospect of their dying on the streets - alone, uncared-for, unkempt, scared.

Our car has been in the workshop and we are taking autorickshaws (3-wheeled cabs) and buses everywhere. I miss mobility, but this city is very well-connected with public transportation and autos, and we are managing. We have also done a lot of hanging-out inside our flat (apartment).

We saw a bunch of movies this week, and ran into Vaishnavi, one of the founders of the Banyan, at "The King's Speech." I had not expected to like the movie, as I do not appreciate disability being milked for the Oscars' sake; however, I did like all the supporting action and the extremely understated humor. Navin is a big fan of Vaish, and the two of them talked like long-lost souls; they are very much alike - intelligent, mildly anti-social, big lovers of animals, compassionate.

I have been in touch with the family of a friend in the U.S. Her father, whom I know well, is hospitalised and I have been chatting with the fam. I am a big fan of parents of friends, and have loved talking with Kris's mom, and Olivia's parents, and Mark's parents; no different with this friend, Ms. C, whom I love dearly. Mr. E, the Dad, is a fun and funny person and all of us like him. I have received many letters from the family, grateful for my notes, and really do not believe I have done anything remarkable, other than love the fam. However, I can well understand the welcome correspondence of concerned friends, which I received myself when my mother was very ill. Like salve.

It's a good life. Our neighbor, Usha, came to ask for a resource to put a young lady in Madurai onto a psychotherapist and we were able to suggest a name (Madurai is my hometown); Usha has done wonders in getting help for the young lady's son, who has special needs. There is nothing as recharging as the ability to help.

Unw -

R

Report of 20 March 2011

2011-03-19T22:49:00.000-07:00

Hello from Chennai and Happy Holi!

There is music blaring from downstairs, and squeals as people try to dodge the squirts of water and colored powder others are throwing on them. It is the harvest festival, imported from North India, and used to be the boys' favorite holiday. People wear old clothes - which they don't mind getting stained - and throw color, water, colored water, etc., as above. There are photos of the boys from previous years - unrecognizable due to the profusion of color on their faces.

I wondered if the music would bother Navin's studying and he said, "Once a year for 2 hours is really ok." I am glad to hear it, the perspective. Naren quickly dodged the color this morning and left for a meeting on International Theatre Day, which is next Sunday. He will be in a play with a friend of his, and we will see it if it's open to the public. We were not allowed to see his ramp walk, as it involved tight security - with all that gold.

Cetirizine is a great drug; sedates, however. I picked up a virus a few days ago, and could not do very much. I gargled madly, and kept the water poured down the old gullet, and feel better. I did pop the pill last night and slept like one, well, drugged. The days of sleeping through the night are likely over - wake up to see the time, if there is some noise, swat the mosquitoes - and last night, uninterrupted sleep was back for one night. I did wake up groggy, but the drippiness has gone. My pharmacy friend, Brent, ordered several bottles of cetirizine for me and boy, was I grateful: they are wonderful aids in my practice of medicine here. As are the ibuprofen, the tylenol, etc. Dispensing such things to the local impoverished people, when they need it, has earned me lots of smiles and greetings and discounted autorickshaw rides for the family.

Our neighbor's maid lost her husband recently. He was not a great provider and was alcoholic, thus the maid is not grieving. Her daughter, who is a college graduate (yes!!!), helped pay her father's medical bills. I talked to the young lady, Ms. E, for a bit the other day; I used to tutor her in English for her college English exam. We have tried to help her find a job worthy of her education and one that will pay well, because the family is extremely poor. Our leads have not been spectacularly successful, but Ms. E has some typical Indian reticence and bashfulness and has not followed up many of the leads. So, right after condoling the death, I had to tell her that jobs do not fall into laps and other such pieces of advice.

We went to listen to live music yesterday - a British singer-songwriter, who was very good. Then Naren's friend, Karan, played with his band. Naren and Aishvarrya came a little bit late, and Scott predicted that Aishvarrya would see us before Naren did. Sure enough. At her urging, they came and sat by us though we did not insist on it, and left before it ended due to other commitments. Aishvarrya is a sweet young woman and doing wonders for Naren's awareness of others.

Scott picked up the boys late one evening, and returned home; he had stopped at a red light when a bus decided to run it (very common here) and rear-ended him. Naren helped fight the good fight (also very common here, which is why foreign companies forbid their employees to drive here) in Tamil, and a police complaint was filed. Thankfully, no one was hurt, which our cook attributes to my mother's protective spirit, and there were plenty of lessons learnt - such as the importance to Scott and Navin of knowing Tamil.

Unw -

R

Report of 15 March 2011

2011-03-15T05:52:00.000-07:00

Hello from the land of the overstuffed -

Today, Naren turned 20 and asked if we could have breakfast at the newly-opened Hilton. But of course: b'day requests, within reason, have to be satisfied. So we went: the place is opulent, beautifully decorated and the service obsequious. The only other guests there were the ones who'd come on someone else's tab. We ate non-Indian food (called "continental food" here) with gusto, and the boys ate waffles and chocolate chip muffins and choco cereal with much glee. It was nice to sit and talk and laugh and soak up the ambience. The service by our waiter was superlative, and he even brought a very nice cake for Naren, which we were too full to eat but which they packed up for us. We took a picture of the waiters and Naren, and complimented our waiter extravagantly to the manager: not enough good things are said in the world, and I must express appreciation when warranted, I feel.

It's very hard not to say "I told you so" to your child when some event that you can see unfolding before your eyes, but which your child is too teenager-ish to see, eventually unfolds, isn't it. I watched Navin's prep for one of his tests earlier, and it was inadequate, and I urged more; the adolescent thought not, went off and took his test and did not do well. I do realise they must make their own mistakes, but it is extremely difficult not to point out that things could certainly have been different. Keeping my mouth shut is always a challenge; today being Naren's b'day, I was determined to keep the mood cheery and tried resolutely to stay upbeat. That went okay, but the "I told you so" kept threatening to roll off the tongue. I have, however, made the mistake of urging caution with the people Navin hangs with, and that went as you might expect - stony silence, a glazed look, and a tangible change in mood.

Our neighbor, Usha, has been invaluable in explaining adolescents to us. We are very fortunate in our friends and neighbors.

The Banyan has been fine. I have also treated folks around our flat, and that has gone well, too. There are several young women here from Chhatisgarh, a most impoverished state, and I stopped to talk to one of them. I am full of admiration for these ladies: they leave their homes and families and crushing poverty behind at a very young age, and take up employment far away. To a person, they are kind and good and pretty, and appear to settle well in Chennai. One of them, Ms. S, calls me "Didi (big sister)," and chatted for a while today, talking about how she can no longer visit her home for longer than 2 weeks, having got used to life outside. I have treated one of them medically, and felt pretty responsible for ensuring the recovery of a young woman, far from home.

Anu and Benji stopped by today to drop off a present for Naren, and had b'day cake and tea. It was good to see them, and I will always appreciate being in touch with my family. Vinu called to wish Naren, they shared some laughs and then I got to talk, which was also good fun. Naren called my father to get his blessings, and my father felt bad that he had forgotten the day, and asked that I give Naren some cash on his behalf; it was nice to talk to my Dad, too.

Unw -

R

Report of 9 March 2011

2011-03-09T04:07:00.000-08:00

Hello from my bright and sunny living room -

A young man is studying in the adjoining dining room, the other young man is off assisting at his college play's rehearsal. It is nice to be able to focus on the family, and I spend much of the day with an apron on, it seems like. I cooked some pasta yesterday, which is really a bit too dreadful for me to eat but which the men devour. We had some rare ice cream today (not homemade); we tend to not stock the treat or many sweets, fruit on the other hand is consumed in vats. We do tend to firmly overeat when there are sweets about, and all are quite unabashed about it.

The Banyan is well, and one of our senior personnel has quit. The senior coordinator, Vanitha, had quit in December, and Harini quit this week. I will miss both folks: the passion they brought to their jobs, their easy manner, quick resolution of difficult situations, their prodigious intellect. It has been a privilege working with both folks and I feel happy for the patients at the Banyan, that they got the benefit of this thunderous expertise.

I continue to field issues on the phone and that is going okay so far. As I have not taken call or wielded a pager for a while, I don't wake up easily, thus I tell the men to answer the phone and wake me up if it's the Banyan. Also to stay until they see that I am lucid: the spouting of nonsense is often de rigeur when I wake up.

Our neighbor brought her maid over, as the lady had some health issues. Ms. D has been abandoned by her husband, and had a plethora of concerns, including stomach ache, headache and weight gain. I took a fairly detailed history, and asked if her husband beat her; even if the man has abandoned her, it is quite commonplace here to see him return for cash, or to beat his spouse for a variety of reasons. Ms. D denied the beatings, but after she left, she told her employer that she had indeed been pounded on the head by her husband many years ago. I sent Ms. D to our local Public Health Center to get her thyroid investigated for her weight gain, and I await the results. Ms. D was sweetly appreciative of my care, and that is the loveliest part of working here: just by using what I call "Wal-mart greeter skills" ("Hi, how are you? Tell me what's bothering you today. How's your daughter? She's in college, isn't she?"), apparently the person feels cared for *and* they are appreciative. Especially in the impoverished populace, I value this interaction.

Ms. D's daughter is in college, and I like that part a lot. Our neighbor helped pay for her education, and that is such a magnanimous gesture. It is education that will lift our young people - especially our young women - out of poverty, ignorance and prejudice.

Sundays are apparently my days, with breakfast to be provided for me. That does not happen with any regularity, but this last Sunday, I was too fatigued to cook and let everybody hear about it in my usual reticent, bashful fashion (ha ha ha). So breakfast was generated, Naren hurried outside to buy a watermelon from our local vendor, Navin got the pastries and juice out, Scott rushed out to buy some eggs and scrambled them, and we ate. And we talked. That is a wonderful time for me: to watch the boys gab and gab, and laugh, and get appreciative of their wacky family. At one time, and I think I've mentioned this before, at least one boy rolled his eyes and said, "Somewhere in the world, some family is having a normal conversation." Now it's said with great affection, and the boys are morphing into adulthood without feeling the need to leave their parents well behind. For this, I am eternally grateful.

We saw "Black Swan," and it was weird. Certainly well-acted, but weird.

My aunt was in town and spent the night with us. She is good company and easygoing. She has coaxed my older aunt, the one with dementia, to move in with her, which is noble. We took my aunt to my brother's place today and I got to see my niece, Ahana; this was fabulous. We don't get to see Ahana very much, and she spoke of school and her uniform and her upcoming graduation from kindergarten. Looking at her was looking in a mirror: she favors our side quite a bit, and I returned, recharged by this interaction.

May you have fine family times of your own.

Unw -

R

Report of 2 March 2011

2011-03-02T04:48:00.000-08:00

Hi from Chennai -

I am eating the last of a chocolate tart made by our beloved bakery, Winners, that trains underprivileged kids. Their fare is uniformly delicious so we buy from there not as a pity party but out of greed and gluttony.

It strikes me that I know the reason for Mother's Day now. We (mothers) appear to do more of the disciplining and correcting and enforcing rules; I had to have a massive argument this morning with at least 1 son and that was not fun. I imagine when I am dead and gone they will remember some lessons. Scott has it easier, like some fathers: does not really get into issues of behavior or healthy practices, manners and courtesy, unless the situation is very far gone. Once a psychiatrist who came to the boys' school to talk to us about drug use told us to keep telling our children of right choices, and that the messages do stick whether it seems that way or not.

When you combine my obsessiveness with teenage rage, the combination cannot be pretty. The boys do fairly well, overall, with tolerating the endless "Get up early, go run, no you cannot have another piece of candy," but it is not without turbulence.

The Banyan is fine. A lot of strange thyroid test reports, and I have had to ask repeatedly whether the patients are taking the meds regularly - on an empty stomach, and daily. I am assured that they are. One of the health care workers (hcw) has a sister, Ms. R, who recently married and had a baby; Ms. R's thyroid results are off and I have asked if she took the meds. Often I encounter patients (impoverished and otherwise) who've listened to non-doctor friends or relatives and taken some faulty decisions; in this case, I think Ms. R was told by friends to stop the thyroid meds as she was pregnant and then nursing, as "it might harm the baby." I am hopeful that she did continue the meds during pregnancy as a normal thyroid is vital for the fetus. I have not heard anything about the baby, but I continue to hope.

Our cook went to her hometown to visit her ailing father. She had described his symptoms to me, and it sounded like either tuberculosis or heart failure or both. I sent some meds, including some precious antihistamines brought from the U.S., and lo and behold, the man is much better. Eating well, walking, etc. I still don't know what the diagnosis is as I have not seen any of the test reports; however, the cook is elated that her father's health is better. As am I.

Illness in a family member can sure rock one's world, can it not.

Scott and I got to see "The Fighter" and "True Grit" and a Tamil movie called "Yudham Sei." This was while Navin was being tutored on successive days. All the flicks were good, and I thought had some solid acting. "The King's Speech" is supposed to release here some day and we hope to see it. All my picks for the main awards at the Oscars won (I thought both Christian Bale and Melissa Leo were outstanding in their roles, we have not seen the other 2 - Portman and Firth), except for Annette Bening, who was very good in "The kids are all right." I was sorry "Winter's Bone" got shut out, but that happens sometimes. It is a great flick, nonetheless.

We bought some extra sarees for the widows that we know employed at the complex and at our house, and gave them. My mother would have wanted that. And so did we. The lady who helps clean our house was 22 when her husband committed suicide; with the sheer tenacity of a piranha, she is educating her children and working to provide for them. Her brother and sister-in-law (our cook) are helping. The boys were particularly delighted with the gifting to the widows; one Diwali, when our cook fasted all day for the good of the family (the men rarely do, the women often), the boys stated that this was a man-made notion, and that no Vedas (our ancient books) would have forced a woman to fast on a festival day surrounded by sweets and goodies that she had made while the men and children ate and made merry. I don't think the Vedas advocate that we ostracise widows, either.

The Board exams are under way and the Board (bored?) boy is studying. He studies with music playing and headphones on, and it is not my way, but it is his. While I don't understand it, I told him forcing him to turn the music off would be like forcing me to study with music on. Naren modelled for a show for the World Gold Council, and said it was exhausting, and that he deserved every paisa of the money he was paid.

Unw -

R

Report of 23 Feb 2011

2011-02-23T00:46:00.000-08:00

And a year has gone by -

A year of altered dynamics, of memories, of trying to get used to life without my mother. We brace for parents' passing, I think, but sometimes an odd trigger sets off sadness. We observed my mother's anniversary yesterday, and gave away sarees and flowers (by local Hindu custom) to 7 impoverished married women - the complex's employess. It is considered a mark of grand good fortune to my mother that she died as a married woman, i.e., not as a widow, and so, 7 women (the number can be a manageable odd number) come and receive some gifts from us and it is to represent my mother coming, and leaving happy and satisfied. Personally, the 3 Weiss men and I also wanted to honor a widowed employee, but our cook - running the show as none of us knew the rites - would have none of it. Widows are treated very poorly, unfortunately, in many parts of my beautiful country and are not welcome at auspicious occasions such as weddings, naming ceremonies of newborns, etc. - very cruel.

My father was in town on Sunday, for us to face the period with togetherness. Susan, my sister-in-law, also came up from Bangalore and that was nice; her presence was fun and therapeutic. A dear friend of ours named Vijaya told me some shlokas (Sanskrit verses) appropriate for the occasion, and I read them out at my mother's photo, of course ended up bawling along with my father (Susan quickly came over and put her arm around me), and then we ate lunch. Yesterday, my mother's favorite foods were made, and at least one of them was a Western dish - stew; my mother was a big fan of Western food and relished steak and fine meats when she visited us in the U.S. - a bit atypical for a Hindu. Yesterday, all of us made the food together, and Naren did the bulk of the cooking with some supervision, Navin made a big salad. That was nice; my mother would have enjoyed all of that.

The Banyan has been good, and I continue to field issues on the phone. I can't currently focus on our perenially underfunded state, but I will do that soon enough.

Navin and I were driving to pick up Scott one day and noticed a crowd at one point. We stopped and went to check, and noticed that a young boy had jumped off a bus and fractured his leg. Our country is so overpopulated that public transport is crowded during peak hours, and it is not at all uncommon to see people hanging off the stairwells of buses, holding on to window bars. This school student had been one of those and had either jumped or fallen. We stopped to render aid, an ambulance was called, and as always, there was a heap of people, including some young men living nearby, who were available to assist me; as I took a dirty rag off a bleeding foot wound and asked about a clean piece of cloth, the young men quickly produced a clean shirt and asked me to tear it. I hesitated, as it was a good shirt, but one of the guys tore it and produced a clean rag for me to bandage the foot. We rendered basic aid, waited for the ambulance, and I told the patient that people had died while travelling on and falling/jumping off "footboards" - the bus stairwells - and for the patient to please not do it again. This morning, Navin and I saw some school kids (not necessarily my patient's group) dangling off the sides of buses, and I groaned.

There have been no movies, etc., as all of us hunker down for the board exams - theory papers start on Monday, 28 Feb. This endeavor truly calls for the whole family to be involved, and no one blinks when parents take leave from work for it. Scott and I managed to get to the beach yesterday - waiting for Navin to finish being tutored! - and that was extremely nice.

Unw -

R

Report of 16 Feb 2011

2011-02-16T05:49:00.000-08:00

Hello from Chennai!

Exams are on us. Navin started practical exams this week, and then theory will go on until 22 March. He will be one of the first to finish; those who have taken arts go on until the 31st. The school will then host a farewell, where the kids speak about their experiences. It's very cool to hear all the kids, and just as in Naren's class, there are several in Navin's class (which is universally considered a weird class) I really like.

My cousin, Dhanu, phoned last week. He has a coffee estate in Coorg, like other Coorgi cousins, and must be doc/vet/counsellor/taskmaster. He narrated the symptoms of one of his workers, and asked if it could be amoebiasis, which Dhanu himself has had. I said it could be, and affirmed the medicine, which was the same one Dhanu had taken; yesterday's text on my cell phone said the labourer was better thanks to me. I told Dhanu he had diagnosed and prescribed the med, and I had little to do.

My father used to come with us to Coorg on summer vacations, and drop us there and return after 2 days' stay. In that time, he and my Uncle (then the owner of the estate and now his son, Dhanu, is) would sit on the verandah, and all the laborers would line up and narrate their symptoms. My father would prescribe the meds, and then label his stash of samples and hand it over to my Uncle, who was very sharp. It was a memorable time, and quite often, the laborers would wait for the non-Coorgi doctor (my father is from Tamil Nadu) as they thought he had kai raasi - a lucky hand, i.e., curative powers.

The Banyan has been well and I get calls regularly about blood tests and such. The health care workers (hcw's - impoverished young women from villages around who come to work for us) are getting very savvy about treating the patients, and I am extremely pleased. At one point, a horde of nursing students had visited, and one of them asked me why I worked at the B; in addition to the obvious, taking care of the destitute and feeling singled out for this blessing, I said I loved watching the hcw's blossom with medical knowledge. It is a treat watching them figure out symptoms, illnesses and treatments for themselves when I teach them, and their list of causes of abdominal pain (or "differential diagnosis" in medical parlance) was impressive.

My sister, Anu, and her family were here on Sunday for a quick breakfast with us and that was grand fun. Our dining table is quite small, but all 8 of us squeezed around it and ate junk - chocolate and pastries - along with some healthy stuff. There was plenty of laughter and that sustained me for the rest of the day. We saw the play "Dirty Dancing" (based on the movie) and enjoyed it, but for the very risque dancing that the prude in me did not want young Indians doing. :)

The anniversary of my mother's passing is 22 Feb, and I miss her. I look at my sons talking and sharing with me, and Scott's unparalleled sense of humor causing all of us to laugh, and think of how much my mother loved all of us - especially Scott, whom she veritably adored.

Unw -

R

Report of 6 Feb 2011

2011-02-05T21:24:00.000-08:00

And another month is on us -

I am in my bright, sunny living room, it is about 75 degrees outside and the sun is happily shining. We have a lone plant on the balcony that is doing so well it is outgrowing its little pot. Neither of us has a green thumb, really, but this plant is a resilient little wonder, doing well in spite of us.

Sundays are good days - no maid or cook, the whole fam here and a leisurely breakfast replete with junk. Often, I let the kids have chocolate with their b'fast and our favorite bakery that trains underprivileged kids churns out very luscious pastries, so we tend to indulge. And then the conversation flows, always the fun part for me. The boys have few secrets from us (I think it's completely appropriate to have some), and even fewer from each other, and are opinionated and insightful, so I enjoy the talks.

I was in Madurai last week to attend Dr. Kurien's funeral. We could not get through to Mrs. Kurien earlier in the week to find out when the funeral was; my sister-in-law, Susan, managed to contact her, so gave us the info that it was to be on Wednesday. Scott and I drove down on Tuesday. The roads are markedly better now, as the Government has realised what developed countries figured out (and had the money for) early on: that roads improve connectivity and trade and the economy. The 480 km (300 miles) was covered in a little over 6 hours, when it used to take 9 or 10 due to terrible roads full of potholes.

Nina (nee Kurien) Zachariah was down from the U.S. and it was good to see her, despite the circumstances. We were classmates from the ages of 10-15, and share things from that era - idiotic jokes, silly crushes, memories of a fun, innocent time. We got to talk for a little bit, and that was lovely. Mrs. Kurien is a dear, and we got to talk to her a little bit, too. I am a fan of physical contact, and like hugs, and think that a touch or a hug or a hand on the shoulder helps morale considerably - especially at such times. My father came with us to the funeral, and saw some old students and friends, so he had plenty of folks to talk to. I got to meet an old student's son, a handsome young man quite our sons' age, and that was fun - the next generation is on to achieve great things. Weddings and funerals - I suppose those are times when we get to see many people in one spot.

My father's cook, Ms. A, is pregnant, and she and her husband are elated. This young lady had been abused ad infinitum by her parents, who seized her money or her jewellery at every opportunity, and her good husband has put a stop to all that. (My father and his friends found said mate and got the young lady married.) The couple is very happy together, and live in a little room behind my parents' house. Last time I was in Madurai, Ms. A, told me of a trip she, her husband and his relatives had taken to a temple near the sea; all had also found time to go to the beach and play in the water, and Ms. A had had a spectacular time. I think it was the first time she had seen the sea, and one of the few times she'd had any sort of happy time, and I was very glad for her. She brought her pregnancy test reports for me to look over, and everything appears to be going along well, except that the young lady needs to lose some weight (not necessarily now); I tell you, it is nice to have the medical knowledge to discern right from wrong. I couldn't escape medicine while away, but that was okay - especially as it involved reassuring a young, anxious mother-to-be, who has not really had a whole lot of good in her life before now.

My father had a full battery of tests done at Christian Medical College Hospital, Vellore, a fine institution where Anu and Benji work, and has to take some meds on a regular basis. On our walk back from the Kuriens' place, I noticed he was panting and had to use his inhaler. On examining him, I heard a wheeze that cleared with deep breathing, and we have come to the conclusion that my father is out of shape and deconditioned; he aims to walk daily, I hope that happens.

We were fortunate to have Greg Brown, also an alumnus of Uthscsa, visit us with his Brazilian friend, Luciana. It is unfailingly a treat to see Greg, and talk and laugh and debate with him, and it was nice to meet Luciana, too. They were nice enough to take us out to dinner at our favorite restaurant - a lovely place with great salads and dessert - that has now priced itself out of our patronage. Greg landed with a heap of chocolate and nuts for us, and I told Luciana it was always good to see him - for more reasons than one :). Greg is a big fan of the Banyan, and took Luciana to see it; she was impressed. It remains a *great* place to work.

Naren was interviewed in the paper about his views on religion and it was a cool article. Navin is cracking the books at his pace. We do not inherit the world from our parents, we merely borrow it from our children - said someone. On two occasions, we have seen our sons' friends outside and had merry conversations with them. Navin's friends once invited me to have ice cream with them, and I stood outside the little kiosk, thinking what a treat it was to interact with the young people.

Unw -

R

Report of 31 Jan 2011

2011-01-31T06:06:00.001-08:00

Hello from exhaustion-land -

We raced around today trying to meet a deadline; complete anathema to me. Scott and Navin work this way, and I think I must have got an ulcer as we had minutes to spare before the deadline lapsed.

My dear friends, Nina and Mrs. Kurien, have lost their father and husband respectively. Dr. K. J. Kurien had not been well, and passed away yesterday. Our families were closely intertwined, and continue to live on the same street in Madurai, and I felt for the Kurien family in their grief.

I have had family illnesses to treat, and that has been relatively easy. I also had a patient to treat by proxy, as our cook narrated his symptoms and I guessed at the diagnosis. This, obviously, is not the optimal way to treat, but happens more often than you'd imagine.

One day, I drove home after dropping Navin at school and at a signal, a man and his son crossed the road. The son was blind, and the man had a firm grip on his hand. They crossed in front of me, with the man gently telling the boy when to step up and down, and I was mesmerised. I do believe, like all parents, that the man would have cheerfully taken on the son's affliction than let his son suffer with it. But they were making the most of the situation, and there is a good school for the blind fairly closeby, which the young boy will receive a nice education at.

We had some good times over the weekend with our own sons, catching some movies including a well-made Tamil movie that unexpectedly had our Madurai friend, Marcus Cleur, in it. He is Anglo-Indian, a very nice guy, and played an Anglo-Indian in the film. I got a kick out of seeing and recognising him. We also saw "The Green Hornet" and "127 Hours." All of us were impressed with the presence of mind of the protagonist in the latter movie, Aron Ralston, but 2 of us found A. R. Rahman's music just a tad mismatched to the situation - and trust me, *all* of us are Rahman fans. Over lunch on Sunday as we discussed the movies, I enjoyed the time and told the boys that if I died the next day, I would die happy. At least one boy did not appreciate that train of thought.

Unw

Report of 26 Jan 2011

2011-01-26T06:13:00.000-08:00

Hello from my breezy living room -

It is Republic Day today, and a holiday for us. Nice. Naren came last night to spend the night, and we did not get to have breakfast together, because our cleaning person (yes, we have that luxury in our overpopulated country) came right then. We don't like to eat in front of her, because we can afford many things that she cannot. But she did share a cup of coffee with us.

It is also the 12th anniversary of my brother Manu's demise. Robust, handsome, full of life, liked to dance, loved his sisters. I could not speak of his passing with any ease, and it has become easier after my mother has passed away; weird. Scott had booked tickets to go to Madurai and accompany my father to the cemetery, but a political party here pulled some stunts and was disciplined; fearing backlash and its repercussions on public life, my father suggested that Scott cancel his trip and he did.

It is a matter of great relief for us that Susan, Manu's widow, has stayed in touch with us and all of us get together regularly. The cousins, in particular, adore each other and that makes me happy.

Let me clarify when I say I've been off from the Banyan: I have taken leave to help Navin prepare for board exams. These are mammoth exams that are taken at the end of classes X and XII, and XII is particularly crucial as it is pre-college; however, the buzz is that potential employers are now asking for 1oth grade marks also. I've taken off for the boys' exams before, and it is de rigeur: ferry them to tutoring, to school for review sessions, ensure they eat on time, keep a carb load handy, etc. This has blown some of our American friends' minds, that parents take time off to see their kids through exams, but it is very commonplace here.

The Banyan has been alright. Before I left, one of our patients, Ms. Ma, consumed drain cleaner. This is not good, as it can corrode on the way down and on the way up (when vomiting). We sent her to the hospital, they did the treating and sent her back, and she did it again the next day. The health care workers who took her the second time said they got an earful from the doctors there, that this had happened again; however, it is very difficult to watch each patient at every moment of the day. During the first episode, Ms. Ma's mother was visiting from a far-off village (she's the one who had refused to take her back, after the Banyan contingent made the arduous trip over there from Chennai) and I asked her if she'd accompany Ms. Ma to the hospital. She flatly refused, and was negotiating to return to said far-off village at mid-day, before her daughter returned from the hospital. I saw Harini, our able occupational therapist, speak with her and Harini was furious; I like anger when it is appropriate, and this time, Harini was definitely justified in being angry that this lady did not give a rip about her daughter.

This is the joy in working at the B. None of us is really very "nice," but we are opinionated, passionate, angry and vocal. I like it.

Some joyous times: my school classmate, Derrick, visited us today with his friend, Bhaskar. Scott and I stayed with Derrick and his most lovely family in Toronto last year, and we were very pleased that he took time out of his busy schedule to visit us. His son, Aaron, is now in Poland studying medicine, and we talked of that and the ladies, Jacqueline and Alisha. They really are a sweet family, and we are pleased to know all of them. Over the weekend, Scott and I managed to get to the U.S. Consulate's free movie screening, for the first time since we moved here. It would have been easier to get into Fort Knox: all the security procedures delayed us a bit, but what the heck - they are apparently essential.

You know, I should be very careful what I say. Soon after Obama was elected, I expressed my joy though I have no great political leanings, and a lucrative U.S. speaking engagement went away, never to be reinstated. I am stricken, however, at the Giffords shooting and the suggestion to put Democrats in "crosshairs;" what sort of advice is that - to kill the opponents?!! The annual goal remains to keep my mouth shut, but you see, I didn't get where I was by doing that: in the homeland, working for the poor, unfunded. :)

We spent a good day today hanging out with the boys. Navin has practice exams and during a break in his studying, all of us watched "Training Day." It is violent and unnerving, but beautifully acted and thought-provoking on issues of ethics and doing the right thing. Especially when watching it with opinionated and thinking teenagers, the aftermath is wonderful: lots of discussions and a perspective that we would not otherwise have thought of.

My top 10 moments from last year (not in any order, except for #1):

10 - Ms. V getting a little steadier with her gait
9 - Spending Christmas with the family
8 - Getting to the alumni reunion and seeing old friends and classmates
7 - Going to the American College of Physicians conference with Scott
6 - Managing to get a wee bit of funds for the Banyan through begging
5 - The boys giving me a collage for Mother's Day, that depicted what they thought of me
4 - Boot Camp workout and spinning
3 - Working in Elwood and Alexandria
2 - My cancer patient cocking a shotgun at Hospice workers (showed his spirit)
1 - Leela reconciling with her brother

Unw -

R

Report of 20 Jan '11

2011-01-20T06:27:00.000-08:00

Hello from my living room -

We have closed the balcony door to keep away the mosquitoes, but a gentle breeze is blowing and it is about 70 degrees outside. Many friends from the U.S. have written of their cold state.

I keep up with the Banyan by phone, and field results of blood tests, etc. 5 patients have died since I left, and I know the cause for 3. It is at times like this that I wish access to a post-mortem was within our grasp: if I knew why the others died, I could do a bit more in the prevention arena. But, as I have said before, we can't order a post-mortem here without insinuating blame, and then the police will try to extract a bribe from the institution where the death occurred, etc. Needless hassle.

That the Banyan exists is a source of great joy for me. Especially when I watch the women eat, I bless Vandana and Vaishnavi for ensuring safe sanctuary and food for those whom their families have cast aside, or whom mental illness has wrecked, or whom poverty has rendered ostracised. I often feel a tremendous sense of blessing when I treat these folks as it is a privilege to do for them. Also, there is very little competition and hurry and bluster - I can take my time, do the prevention bit, teach the health care workers about the patients and themselves, gab with the senior coordinators, check in on our older patients. It was even better when a Canadian volunteer trained some of our residents in massage, in preparation for sending them out for employment; I used to willingly pay for experimental massages by these ladies and it was fabulous.

Some fun times last week. Vandana's 40th b'day was 17 Jan, and she had a party on 16 Jan. Scott was out of town, and the boys and I went. Vandana, her husband, Senthil, and Vaishnavi made us feel welcome and important. The boys were in sherwanis - traditional Indian clothes (bought in Bhopal), consisting of pants gathered at the ankles and long tunics, along with a stole worn around the neck - and looked nice. We saw several people at the party that we know and like (that's one of the pleasures of working at the B, too, and Vaishnavi's parents are singular joys in this regard), and as we went to dinner, saw that the dance floor was empty and a hopeful DJ spinning some tunes. Navin, often painfully shy but kindly willing to join me, and I danced, and then others joined in, freeing Navin up to hold up the wall with a friend. Naren then danced, also, with his girlfriend and her mother and all of it was fun. I like this pair of ladies a lot, and we spent a very nice evening, mostly dancing and yelling to be heard.

The boys and I went to breakfast on Sunday, and it was nice to sit and talk and laugh. As the boys morph into adulthood, I continue to enjoy their opinions and chatter. At one point during a meal, one son said, "Can you imagine someone being scared to tell their parents they're gay?," and the other said, "Yeah, really." And that was nice, that they know us enough to know that such disclosures would not cause our world to split apart.

Chennai Sangamam, the street festival of folk arts, was on last week and Navin and I caught a show or 2. Naren was busy with college stuff, but did manage to join us for the aforementioned breakfast.

The annual conference of the American College of Physicians is coming up, and it is always a great show, full of learning. However, the fare to get there is hefty and I am on the prowl for speaking opps, etc. Someday, work with the destitute will get the attention it deserves; none of us is under any illusion that it will get the finances it so desperately needs. But the work, undoubtedly, will go on - enriching us, more often, than the patients.

Unw -

R

Report of 13 Jan 2011

2011-01-12T20:46:00.000-08:00

Hello from Chennai -

The blog is getting a bit erratic, isn't it. Scott is away in Trivandrum, Kerala, with the computer, so access is interrupted. But I'll try to keep up.

"Days off work" I thought, but days off they ain't. Lots to be done, academics to be kept up with, my professional journals to be read. As Navin worked on a project to be submitted for a grade, I noticed that I was getting a bit obsessed with ensuring a good job. Then I backed off - what he sows, he reaps. Naren has been roped in to assist, because the boys tend to listen to each other more. When Naren got into a spot of trouble last year, Navin eloquently argued his case, diminishing the former's punishment. When Navin had a vat of studying to complete, before our return from Bhopal, it was Naren who coaxed him to "finish 2 pages before the plane takes off, because it's just sitting on the runway now."

My aunt, my mother's older sister in Mysore, has the beginnings of dementia: gets lost going to or from the store, does not remember that her parents are not living, does not know me. That is sad to see. As I quizzed her extensively, trying to judge if this was dementia or just loss of memory, she started to get a tad defensive about her memory lapses. My aunt is a fiery one: when she worked as a hospital administrator for one of the biggest hospitals in Delhi, she noticed that a hospitalised minister (politician) was dipping into the poor fund for his treatment. This fund was reserved to treat impoverished patients. My aunt made this public and resigned; it made big news, and she got marriage proposals (in her 50's) from as far away as Australia. She had already chosen not to marry ("Chee, who can spend her whole life staring at one man's face?"), moved to Mysore and indulged her love of reading and cards (rummy for money was a favorite). I am actually surprised that my aunt has been afflicted with dementia, because she was a voracious reader and kept her intellect sharp; however, maybe living alone and losing 2 of her closest siblings caused more and more reticence. My cousin, Sheila (my mother's brother's daughter - our parents did not speak to each other as my mother married outside the community), and I are in discussions about this aunt - a fairly beloved figure as she is affectionate, loving and chose to stay out of the gossip that is endemic in the Coorgi community (and our family).

Dementia is a cruel animal. At one point during my training at St. V, our inpatient team cared for an older lady with it; she was hospitalised for pneumonia. She recovered from the pneumonia, and one day, in her daily session with the physical therapist, her daughter walked in; when the physio asked the patient who that was, she answered, "That's my daughter." The daughter was elated, because the mother had not recognised her for years. I think the recognition was transient, but it made the daughter's day, and consequently, ours.

Lots of little illnesses around our apartment, also. All treatable.

My father was awarded the Lifetime Achievement award in plastic surgery from the Dr. MGR Medical University here, and came to Chennai last week. I don't know what the big deal is with awards, but we went for the ceremony and it was nice: it was combined with this year's graduation and it was a treat to see the senses of achievement in the graduates and prize-winners. We hosted a dinner at our house for the family, and Anu and family, and Vinu, Tina and Ahana came. Tina made some wonderful fish cutlets (patties), which all enjoyed, and some banana cake, which was also yummy. I tell you, it's awfully nice when folks bring food to share - especially tasty stuff. It was nice to have the family together, we missed Susan at this time, and my Dad was happy at the get-together.

Navin and I saw "Fair Game," and that prompted a lot of discussion. Indian school-children are well-informed and opinionated, and that makes for some lively conversation. Naren came last night to spend the night, and the flick has been recommended to him.

Scott's grandmother died last week and the funeral was yesterday. I remember how warmly she welcomed me into the family, and am glad the passing was peaceful.

Unw -

r

Report of 3 Jan 2011

2011-01-03T06:08:00.001-08:00

Happy New Year to all of you!

May good health and happiness come your way all through the year.

It has been a tumultous 3 weeks since the last write. A beloved colleague, R, committed suicide. He had been successfully treated for a mental illness at the Institute of Mental Health (IMH), joined us at the Banyan, married a Banyan resident and fathered a very cute baby. Marital troubles ensued and on a Monday, just after several counselling sessions for the family with senior staff, R went home and hanged himself. We were stricken; he was a great guy, with a cheerful disposition, and an ever-present smile.

My patient, Ms. G, rescued from the street, started to lose weight in front of my eyes and began looking skeletal. I strongly suspected cancer (I think this is in a previous blog) and then, propitiously or otherwise, Ms. G had vaginal bleeding. We sent her to the doctor, they sent her back with a non-committal opinion, I was furious and sent her elsewhere for a second opinion; they confirmed the cancer and sent her back. I had a diagnosis, which I often don't in others who die: getting a post-mortem here involves casting blame on the institution (whether the hospital or the Banyan) and all are loath to do that. Ms. G died days after the diagnosis. In the interim period, I gave up attempts to make her sit for a while and let her lie in bed, ordered her favorite foods, and sat with her whenever I went to the B. She would say that she wanted to come home with me, or that she wanted me to sit in the room, and I would point to my chair and say that I'd be right there, in the room with her; she'd then say, "Khiladi," which mentions "mischievous" or "fibber." I would sit and talk to her, and put my hand on her back, feel just her bones, tell her how all of us were around her, and try and ease her giant apprehension at being alone. As I told our able occupational therapist, Harini, I was glad Ms. G had a warm, loving place for her last days.

Training the health care workers (hcw's) went along well until R's demise, and then it had to be suspended as no one was in the mood to learn. The hcw's are tremendously good beings.

I had mailed candy from the U.S. - Easter candy on clearance, Christmas candy available in May!! It cost me about $60, which was not really within my budget, and I privately berated myself for sending idiotic stuff. The candy was for children of staff members (most of whom are impoverished), and was handed out just before Christmas. Several colleagues came up to me after the receptionist gave out the gifts, and were rapturous about the novel (American) candy, and stated how much their kids would love it: seeing all the smiles, and the parental joy, and the wonder at the novelties, the $60 became a worthwhile expense. I was delighted to share the goodies, and was very happy that all the parents thought well of the gifts.

Naren was in the annual city pantomime and I saw the show 4 times. He sang and danced with gay abandon, and that was fun to watch. The panto invites heckling from the audience and I obliged with gusto; several of the main characters (including Naren) heckled back and I loved it. One of them even said things like "Yo, hot lady at the back," which, of course, fills every vanity requirement in us older women.

The 3 Weiss men and I travelled to Coorg and saw relatives, then met the rest of the family at my sister Anu's place in Vellore on Christmas day. We did not really celebrate, due to my mother's passing last year, but enjoyed each other's company and ate like pigs. All came to our house for lunch the next day, as Chennai is quite the central point for onward train and plane journeys, and that was fun. Our cook, Ajitha, outdid herself with the meal and everyone ate some more. My sister-in-law, Susan, and her kids spent a couple of days with us and that was a blast: we went out to eat and saw a movie ("The Tourist"), which all enjoyed. The Weiss family went to Bhopal for a short holiday, and that was nice: so much grandeur in our own country.

It is now time to focus on Navin's exams for Class XII. They are mammoth, and require a lot of effort - from him and me. :) We worked on some essays together, and it was cool to spend that time with the boy, getting to see a different side of him.

Each day brings a new activity or requirement, and I am glad to have 3 months off to balance all of it. There are wonderful perks to being able to spend time with the family, whether in the midst of exams or not.

Hope your year is great!

Unw -

R

Report of 13 Dec '10

2010-12-12T21:55:00.000-08:00

Hello from Chennai -

We are well and hope the same with you. I have enjoyed getting emails from people across the oceans and am grateful to all who have donated to the B. This is a lean season for us.

The Banyan continues to be good. I am mesmerised by the patient we rescued most recently from the streets. Ms. G speaks Tamil, Hindi and some English. I had not seen her for about 10 days (details later), and found her *more* emaciated, if possible. She was not, by any stretch, fat or even a healthy weight to start with. She's had some vaginal bleeding, and I am terrified that this may be indicative of cancer. I have asked for an evaluation and we will go from there. The social workers tried to locate Ms. G's family, and were unsuccessful. I have insisted that Ms. G sit in a chair for some time every day, and she does not like this - she'd rather lie down all day. One day, she tried to negotiate with the nurse and, failing that, turned to me and said something; I did not hear it and asked the nurse what she'd said. Ms. G said, "I said Babloo." "Babloo" is a pet name, or one of great affection, and I was touched and saddened: in a past life, Ms. G had probably Babloo'd a niece or son or grandchild, and now I was the recipient as her family was nowhere in sight.

The rains lashed the city last week and all but wiped out access to Mogappair. I did not take my car to work last week, but took an autorickshaw - a 3-wheeled cab. The auto driver had a tough time getting there, too. This happens annually: rains arrive, massive road damage ensues and then cars routinely go into workshops. Unfortunately, loss of lives due to hidden/submerged potholes has also happened. Scott, my civil engineer husband, says if the roads are laid down using best practices and no corruption in contracts (still an elusive concept here), they would last years. As of now, the roads last "year" - one year, until the monsoons come again. I had to work from home a couple of days last week as there was absolutely no way for me to get to work. When I got there last Thursday, the Banyan drivers urged me not to take my car out for a few days longer.

Scott told the boys of snowfalls in the U.S., that when schools would close and he'd stay home from work, I'd take the car out and head to work. He said he knew then who "essential personnel" were. I don't have the luxury of getting to work in extreme weather here, as the roads get wiped out.

We got together with my wonderful friend Joan and her family, to give thanks for her mother-in-law's life after she passed away early last week. Mrs. Pandian was a warm, loving, hospitable person and we have partaken of her legendary cakes and her hospitality. Joan's husband, Mohanraj, is also a really lovely sort, and, barring the solemnity of the occasion, it was nice to get together with the whole family. Patricia, Joan's very sweet daughter, sang a beautiful solo at the service and it was moving beyond belief.

A few events to celebrate: our dear friends, Kris and Gabe, welcomed daughter #3 - Gabriella Georgena; my long-time friend, Tori, welcomed granddaughter Hayden Grace. We are super glad to hear of these happenings! There have been other events to celebrate, too, undoubtedly, and I will hear of them.

Exam season is on for schools and my schoolgoing son, Navin, is attempting to study. Collegiate liberal arts education is very easy in India, and Naren does not have as much to study. He is in the annual pantomime staged by the Little Theatre, and we will see it later this week. Scott and I managed to get away to the beach, and it was nice to sit and talk. I got to talk to my father, too; he enjoys this season - the music and the bonhomie - and had attended several carol services.

It is very, very nice to be within talking/driving/reaching distance of the family. I remember thinking this as I sat at my mother's bedside and read to her and kissed her warm, beautiful face.

May the spirit of Christmas give you peace and family joys - whatever your family may be.

Unw -

R

Report of 6 Dec '10

2010-12-06T05:32:00.000-08:00

And it's time to build an ark.

The Northeast Monsoon has brought rain unceasingly for 2 days. Today, all schools and colleges were closed, and Scott and I did not go to work. Naren came to visit last night and stayed the night, and I dropped him at the train station today. On return, I hit a pothole of epic proportions, cleverly concealed by rain water, and damaged the power steering fluid link. Scott took the vehicle to the mechanic, and we now have the car back. One does not appreciate power steering until one is without it, as with several other things.

The Banyan is fine. We had a new volunteer start: she is a physician about to emigrate to the U.S. and wants to continue volunteering with the B on her visits here. I encourage it. We talked about how nice it was to do for other women, because, in society's eyes here, everything is the woman's fault: if she has a mental illness, if her husband has it, if they have a daughter, if some ill befalls the family, whatever - everything is blamed on the woman. And yes, you read that right: in some families, it is considered a curse to have a daughter, as her wedding expenses will nearly drive the family to bankruptcy. It's nice to be on the helping side. I am grateful to Vandana and Vaishnavi that they founded this magnificent organisation.

Our mentally disabled (there's a difference between that and mentally ill) patient, Ms. M, is up in the dorm now. There's another Ms. M in the sick room and she'll be there for a bit, as her gait is not strong enough to let her be upstairs. She had climbed her bunk bed and fallen from it, so we think it best that she be where she can be seen. Hema, one of our intrepid and dedicated volunteers, also the person who runs "Friends of the Banyan" in the U.S., had sent Ms. M a sheet of stickers and they are pasted all over the sick room now. They really do make the place look cheery and fun: God bless Hema. The dorm Ms. M came up to me the other day, with a very happy smile, and she and I chatted for a bit about what she had eaten for breakfast, etc. She answers all my questions correctly; I do think she had not been sent to school as a child because the family was worried about the stigma of the mental disability. Shame. She would have been a quick learner, as she is now.

We continue to struggle with leptospirosis and the blooming rats. With the monsoon, I hope that's the extent of our woes. The residents do, however, drink from the faucet and that becomes eminently unsafe at monsoon time.

I got to sit with some of the senior health care workers for lunch the other day - all of us went late - and enjoyed that immensely. I am very fond of these young women - impoverished, dedicated, so willing to learn, fun, funny, good people. At the end of the meal, I mentioned how much I'd enjoyed it, and we parted ways.

The lady gardening assistant at our apartment complex gave me a grand salaam the other day, and when I asked how she was (she's the one with hip pain), she said she was out of the med (Ibuprofen); I told her I'd write its name down and she could get it at the store. My stash tends to run out quickly and I think it's affordable, even for the impoverished, so I will have my patient buy the meds herself. It would be nice to subsidise everyone's requests, wouldn't it, but that's not realistic.

Our neighbor, Usha, a wonderful resource with advice on our boys, chairs a facility for special needs children; it is named Vidya Sagar. She has involved Naren with helping one of his collegemates, K, a young man with cerebral palsy and in a wheelchair, get off the city bus. Our facilities are not very disabled-friendly, and the poor young man needs help to get off the bus and to get to his class. His mother travels to college with him every day and waits for him to get done; she told Naren that the bus driver and conductor were reluctant to help, and acted like the disability was contagious. So Naren gets K off the bus and takes him to class; he said it was "rewarding." I am delighted. Nothing like tapping the hearts of these young men and helping them realise there is a whole populace out there who'd like to be included. I notice also that Naren's arms are more muscular, and he mentions that he must get up early and eat breakfast before he gets K, othewise K's mother buys Naren breakfast; Naren had previously got up late and missed breakfast, etc., none of which helped his overall state of health. Helping K is also helping Naren, which is a great bonus.

Navin appears to be taking his studies a bit seriously. We hope for the best. His school is inclusive and there are students from various sections of society, and some special needs kids, all of which we like. If we do for folks without it seeming like a major production, it goes that much farther towards making such activities as natural as breathing.

Scott and I managed to get away for lunch and a dreadful Tamil movie called "Ratha Charithram." It was billed as a multi-starrer, etc., and has an actor named Suriya whom I really like; however, it was violent and unentertaining. Lunch, however, was great; when the waiter noticed my disappointment at the absence of fish at the buffet, he asked if he could make a special order for us - on the house. I agreed joyously, and he packed the leftovers for us, which I thought was an exceptionally kind gesture.

If you think you could spare $15 to sponsor a Banyan resident this Christmas, please email fotb.usa@gmail.com. We would appreciate that immensely. Thank you.

Unw -

R

Report of 1 Dec '10

2010-11-30T21:25:00.000-08:00

And 'tis the month of Christmas -

Hope all are well. I like this season. The festive air; spirit of peace, harmony and forgiveness; and the music, ah yes, the music. "Oh, holy night" is a particular favorite. I did not like the rank commercialisation of this holiday in the U.S., and the fact that folks went heavily in debt to "buy Christmas." My in-laws were very sensible about this: each adult picked a name from the pool of relatives and bought a gift under $25. Adults were welcome to get what they wanted for the kids.

Speaking of in-laws, Scott's uncle died last week. He was a very nice man. Scott said it would have been nice to be with the family then, and I agree.

The Banyan is good, as always. Ms. S, our deaf mute patient, continues to tell us that she wants to go home, we continue to tell her we need to know where that is. She cannot write, or read, and when I told her I needed the info, she went off, grabbed a pen, scrawled a pattern on her hand and returned to show it to me. I felt sorry. We have a long way to go to get this info, but perhaps our media friends can help us.

An English-speaking patient, Ms. T, is with us, and is in the sick room recovering from malaria. I looked at her file and saw that she'd quarrelled with her family and left about 7 years ago. There have since been romantic relationships, pregnancies and abortions, and most recently, 1 steady partner and a son. We have contacted her extended family, and they said they'd had no word of her for 7 years and would come as soon as they could; I asked Ms. T to please not fight with them when they come. She has agreed.

What manner of events happen, eh - fights enough to splinter the family, likely lack of recognition of a mental illness, the departure of a family member, sexual experimentation, thankfully now no dreadful disease to show for all this. I am grateful that my family endured all our teenage tantrums, and drilled it into our heads that pre-marital intimacy was a definite no-no. I am, indeed, thankful for a great many things in my upbringing, including my parents' neutrality: I know families where the parents go willingly along with their child's feuds with in-laws. Does not teach the child anything, except to continue pointless fights.

There was some fantastic news in the paper recently: Myanmar's Aung San Suu Kyi has been released! I was *elated*! The poor lady had been under house arrest, her white husband had died in the meantime and she could not go to the U.K. for the funeral, it had been 10 years since she'd seen her sons, had never seen her grandkids. All this because she opposed Myanmar's repressive, dictatorial, military regime, and won elections subsequently nullified by the ruling militia. I cannot imagine absences from my family lengthier than my usual overseas working stints. I am glad Ms. Suu Kyi is free, I hope Myanmar's condition improves.

The teenagers have been up to their usual shenanigans, including blatantly taking their father for a ride. Our dear friend, Mrs. Kurien, said at least 1 parent must be strict, so I have played Demon Witch Gorgon Ogress and instituted penalties. When one of the boys said earlier that I appeared to like punishing them, I said I'd appreciate nothing better than peace, quiet and kids who realised their potential. Someday, these characters might understand that.

I was in Madurai last week for the day, and enjoyed seeing my Dad. He had at least 3 appointments outside the house and kept all of them. I also enjoyed catching up with Mrs. Kurien in Madurai, and we had a nice gabbing session, with guavas and other goodies as accompaniments. Scott was out of town on Saturday, and Navin and I went to see a very good Tamil movie called "Nandalala." Naren joined us for breakfast the following morning and it was nice to see the boys, though shenanigans had ensued in the interim. I'll say this much: it is good to have honesty from the boys. We always know much of what they have pulled, though of course some will stay secret until we are 80.

Scott and I were at the beach Sunday, and it was extremely nice to spend time by ourselves. A pretty little girl came selling jasmine, and when I looked at her, I asked how long she had been selling flowers. She said, "I know you, you told me 2 years ago that I had to stay in school until 12th grade." We've seen this child before, and she is a cutie. I told her how glad I was that she was in school, and she said she stands second in class (Grade VI), which pleased me even more. I told her to consider college, and started to buy jasmine for 10 Rupees, but we'd left our money in the car and I could not. I said I'd catch her next time, she said okay and left; when I told Scott that she'd accepted my answer (of no cash) readily, he said, "She knows she'll see you again," and I said, "Yes, and I'll buy for 20 Rupees next time."

I love living here.

Unw -

R

Report of 22 Nov '10

2010-11-21T23:26:00.000-08:00

Hello from the B -

And time is flying. I have not read any of my professional journals for the last 4 days and I feel the void. Family responsibilities and health issues have superseded much else.

I just finished a training session for the employees of our Day Care center. There is an urban center where family members of mentally ill folks drop off mentally ill patients. The employees wanted to know about first aid - very responsible, I thought. We did not stop with first aid; we went through the causes of why the heart would stop, prevention being better than cure, etc. It was nice; well-informed folks make our jobs easier.

The B is good. We have a patient, Ms. S, who greeted me with a big hug the other day. As I wondered about the sudden affection, I was informed that Ms. S had gone back to her family up North and then had apparently refused to take her meds, so relapsed and was brought back. She is much thinner, and while I think appropriate size is a fine thing, I am also reminded that many of our patients cannot afford food. When I give patients advice such as, "Try and give your kids an egg a day," I realise that it is not within many folks' budgets. And if I say, "At night, I need you to give hot water fomentation to your aching muscles," I often see that hot water is not within a lot of people's budgets, either. We must do what we can with what we have.

Ms. S waxed eloquent with what appeared to be a litany of complaints. I don't speak Oriya, our security guard does, so I took her over to him and asked him to translate. He said, "This is not Oriya," and then translated. I was puzzled and asked what was going on: he said that Ms. S was interspersing Oriya with something else, and then said, "See, since she is sick up here (pointing to his head), she says things I don't completely understand." However, he had done a fair job of communicating her message, and I told him to tell her that she would get her slippers and earrings back (the staff had put aside her gold earrings for safekeeping, as many things can happen with precious gold in crowded living situations).

One sick young son trotted back from the dorm with an abscess on his elbow. I became useful, suddenly :). We started an antibiotic, and I had him soak his elbow in hot water, and it was healing, then he went off and ostensibly waved the arm around, so it swelled up again. The following morning, I told him tentatively of the need to rest it in order for it to complete its healing, and then sat back and waited for the barrage of, "What do you mean, rest it? Do you know my play is only days away? How can I give up rehearsal?" Instead, there was, "Yeah, that was what my director said, too. I'll rest it today." The family picked me up off the floor, and I had to thank the director for his message. We are trying to negotiate similarly reasonably on another young man's academics, and that is a big challenge, also. He is capable of more, but the adolescent wiring simply prevents harder effort - boggles my mind. I asked the boys once why they fought with me, and not their Dad, nonstop, and one of them said, "It's hard to fight with someone who does not say anything." I should really learn from Scott, shouldn't I.

We attended a couple of concerts and enjoyed them, and took both boys out for lunch, since we had their rare presence on a weekend. The menu was Indo-Chinese food, the boys said it was too spicy for them, and I loved it. Conversation was involved and stimulating; the boys talked of how they declined offers to drink or smoke dope, and were left alone after it. When I expressed surprise, they said, "Come on, a billion people, they can find someone else to smoke dope with." They advocated legalisation of alcohol and marijuana, so that the temptation of forbidden fruit is removed, and we discussed that at length. I have to admit that there are very few young people hooked on prescription meds here, where they are plentifully available without a prescription, than in the U.S., where they are so tightly regulated. We also saw "Harry Potter and the Deathly Hallows," with a very rambunctious theater crowd, and enjoyed it in spite of the side bar chatter.

I talked to my Dad last week, and he spoke of having to officiate at some endowment lecture where the speaker droned on. My Dad and I are not fans of lengthy speeches, and we chuckled about this. Scott and I managed to get away on Bakrid by ourselves, and had a very nice day - lunch and chit chat, very nice away from parental pressures.

Unw -

Report of 15 Nov '10

2010-11-14T22:09:00.000-08:00

Hello from the B -

Our car is in the workshop and I took the train today. 7.15 AM is reasonably the last train that won't be packed, though the 7.35 one is bearable too; I like heading off early, so these timings work for me. I took a 9 AM train once, after dropping off my visiting father at the airport, I think, and part of my bod was hanging outside the compartment; a fellow passenger looked at me with great concern and tried to squeeze me in, however, there are just so many sardines you can pack in a can. Overpopulation is alive and well in India.

The city is well-connected, though; sans car, all of us have managed to get where we needed to go, sometimes with a little getting up earlier, or walking some more, or adjusting responsibilities a bit.

I walked through the open-air slum to get here. It had rained earlier, and I imagine all the occupants scrambled to get into the station and shelter. The rain stopped by the time I reached Chetpet, and the slum folks were back in the slum. These are not Tamil-speaking people, and I think they are part of the vast migration of folks coming to Tamil Nadu to seek work: we are a safe state, thank goodness and knock on wood, with plenty of religious tolerance and a fairly robust economy. I did notice a non-Tamilian person begging at the station, and it is a shame that that is considered an option for livelihood. But let's not discriminate, shall we; there are plenty of Tamilian beggars, too. There was an article by Harsh Mander, a prominent social worker, in yesterday's paper and he talked about how wretched impoverished parents felt when they could not feed their kids. I understand this very well: when I watch the family eat, I am always eternally grateful that we can afford to. Even the dreadful mac and cheese, and the pudding that must be made from scratch (dissolve gelatin, boil milk, dissolve cocoa and sugar, mix the 2 liquids - milk and gelatin-water) give joy, and it's nice that we can afford the food we like to eat. I remember my mother and I sharing this sentiment.

When I crusade for women to limit breeding to 2, I use the example of breaking an idli (a steamed rice patty) into 6 pieces versus 4, and speak of how increased numbers of people translates to less food for each person. It's variably successful. Why don't I target men? It does not elicit the same response that targeting women does, as the Grameen Bank found out long ago: lend to women, they take care of the families; lend to men, not quite the same result.

The B is doing well. Our patient, Ms. Ma, was doing very well at work and has now had a relapse. She is belligerent, picks fights, is unhappy and not the same person she had evolved to be. She's the one who followed me into the sick room last week, and I asked for special permission for her to stay. An attempt had been made to rehabilitate her last year, and the team managed to reach her village and locate her family (no mean feat, I assure you - especially the long train journey, where the staff take turns staying alert even at night so that a resident does not get down at a station en route and wander off), and then the mother said she would not take her back. It was pretty heart-rending, and Ms. Ma came back thoroughly torn; the psychologists, psychiatrists, social workers and other staff worked overtime to reinstate Ms. Ma's self-esteem and I think it might be working. She must recover from this relapse of her psychiatric illness, and we can get her to be productive and happy again.

Productive and happy - the name of the Banyan's game. When we treat a woman's illness and give her earning power, all manner of happiness happens: improved self-esteem, self-confidence, a notion that she can solve her problems herself, take care of the family, etc., etc. Nice.

Navin's school trip to the hills (Kodaikanal) was cancelled due to landslides and so, he and Naren were coaxed to dance at our complex's Children's Day celebrations. I appreciated the accommodation the boys made, dancing to a pulse-pounding, joyously exuberant Tamil film song, and then Naren fled to act in his play. We had seen it earlier, and had enjoyed it. The boys continue to get into arguments with us with regularity, but I'd rather they do that and communicate and share, than do other things with their anger. We saw a Tamil film ("Mynaa") and had lunch together, and enjoyed that; as we sat talking over lunch, we asked our favorite water if we could dawdle a bit over the meal, and he said, "Of course, we close at 11 PM." And all laughed.

Unw -

R

Report of 11 Nov '10

2010-11-11T04:31:00.000-08:00

Hello from Virus-ville:

Navin came home with "pink eye" (conjunctivitis or "Madras eye") last week, Naren caught it the next day in his short visit home and then Scott and I partook. No clearer evidence of age than this: the boys have been over it in a couple of days, and Scott and I are still dripping antibiotic eye drops in each other's eyes almost a week later.

But work has been fabulous - if my life span is 90, I do think I will work until then. The Northeast monsoon is here and as I got to the B one day in a very ethnicky skirt set gifted by Vandana, a car drove by and splooshed muddy water all over my outfit. But that was the least of my worries: we had to ensure that the monsoon did not yield gastroenteritis and malaria, and related ills. The emphasis on hygiene continues to exist at the B, so I think we'll be okay.

Our patient, Ms. M, says she is going home. She describes the village in some detail, and I ask with great sadness (as I know for a fact that Ms. M's family has abandoned her and there is no remote possibility of her going home) who is there: she describes her brothers and their wives and children, and asks if that is not enough. I cannot tell her she cannot go home, so I engage her in conversation and then she asks, as usual: "Are you married?" Yes. "Is your husband with you?" This is particularly wrenching, because her husband abandoned her and married someone else. I say yes. We talk for a few minutes and then I write in her file for the psychiatrist, psychologist and social worker to see her, to address this desire to go home. I wish more residents' relatives visited: it would assuage the patients and fill a need that we absolutely cannot, try though we may.

Our new patient, Ms. Se, is HIV+ and just recovered from an attack of leptospirosis. She is hard at work in the sick room; many of our residents are employed in various capacities and are paid. Ms. Se can apparently tolerate the bad mood of many a sick room patient and works non-stop. Sharon, my friend in Houston, had given me some fruit snacks and I took them for the children of our staff members; Sharon had also given me raisins for the B, which the Banyan residents and staff got. I love when friends give us treats for the B: they are so rare that they quite make the day for our residents and staff. There was a little bag of fruit snacks left, so I took it to the sick room; Ms. Se got one tiny fruit gummy. I asked if it was good, and she said yes. Another resident had followed me in to the sick room and would not leave, and I said it was okay for her to stay for a little while; she got a gummy, too, and said in Hindi, "I have not eaten a sweet like this before. It is so tasty." This is part of the reason I love working for the poor - one little treat, a tiny gesture, even just a smile and a greeting, and they become very happy. Ms. Se is a delight; in the midst of working, as I ask her if she has eaten, she replies - mostly with her eyes. She and I do not speak the same language, but communicate nonetheless; as I watch her work away, I realise that she left a husband and children, either voluntarily or was forced, due to her mental illness. I wonder, as a fellow mother, if she wonders how her children are, whether she hopes they are eating right and doing their homework, if their hair is combed and if her daughter gets the green ribbon that she so likes. But there is not a trace of sadness in her spirit, and she has made the best of her new surroundings (I am guessing this is better than the street), and smiles at me with her mouth, her eyes and in fact, her whole being. Very wonderful to see.

The Banyan Academy of Leadership in Mental Health (BALM) and University College London (UCL) conducted their fourth course together, this year titled "Rethinking Psychosocial Interventions in South Asia." I was deputed to go and was well enough to attend days 2 and 3. To sit in the middle of such intelligentsia, to listen to arguments and opinions and facts artfully said, all of this was a treat. Vandana and I were in the same small group, and as usual, I had to pick my jaw up off the floor after listening to her dissect a problem and offer a solution in about six sentences; truly heady to be in such august and erudite company. Mental health is not completely my bag, but I love learning new things and this fit the bill. I had to be very careful not to shake hands, but the evidence of my illness was writ large in my very puffy and red eyes, so no one hastened to touch me. :)

The boys are well. We have just had discussions with Naren about his love life, and then he has pronounced that he really does not want to come home for any great time over the holidays, as he cannot abide the rules here (Get up early, exercise, eat right), and wants to spend NY Eve by himself (not necessarily with the romantic interest - just away from us :) ). Candor is a good thing. Hurt can be a consequence. Adolescence will bring about an almost visceral need to hang out with "friends" in the holiday break. I messaged him later, told him he was welcome to his NY Eve plans, and said I would love him regardless of his choices, as indeed I will. Motherhood is not for the faint. Navin continues to consider academics a distant second over reading fantasy books and gabbing with friends, and I do hope his cosmos comes in alignment with ours at some point. Overall, though, it is good that the boys choose to communicate with us; they could be devising all sorts of alternatives to cope with teenage angst.

I talked to my father today, and he was surprised at UCL's choice to collaborate with us - "Oh, has the Banyan done anything worthwhile in the field of mental health?" Where has he been? He refers friends constantly to be treated by our psychiatrists, and then considers us some sort of random, earnest organisation with no success stories to speak of. It would be funny if it were not annoying. But really, it is better for us to be low-key about our many successes - if the residents are happy, we are happy.

Unw -

R

Report of 1 Nov '10

2010-10-31T22:54:00.000-07:00

Hello from the Banyan -

We are well, and hope to hear the same from you. Diwali is 4 days away, and we are counting down to the day, avidly hoping we'll have cash for the festivities to give all the patients food and treats, and not have to rely on credit.

It is nice to be home. Before I left, I'd had to treat our apartment complex's gardening assistant, who'd reeled under hip and leg pain for a long time. She said that she could not even walk on occasion. She is of the extremely impoverished class, and cannot really afford a day off from work. I examined her, thought she had some inflammation from arthritis, and gave her some Ibuprofen, which various individuals in the U.S. have either kindly financed or donated. My suggestion was also that she get an x-ray at a local public health center (PHC), because I wanted to see how her hip looked on film. I saw her a few days ago, and asked how she was, whether she'd got the xray done; she said she hadn't been to the PHC because she'd felt so much better and was back at work with a spring in her step. I was extremely pleased to hear this.

Ibuprofen - the wonder drug. I travel with it now.

Some fine times last week before I left the U.S. - I did see Tori Scott, and loved that. Scott and I met Tori and Jerry Scott when we moved to Houston; they had 1-1/2 year old Jordan then, and we found out we were expecting Naren, and it was the merry time that young parents are wont to have. They have subsequently added Caithn, as we have added Navin, and I feel privileged that Tori and I have stayed in touch. Jordan and his girlfriend are expecting a baby, and Tori is about to be a grandmother; we talked about this over lunch, which Tori kindly treated me to though it was on my invitation, and then she was magnanimous enough to take me shopping - which I abhor. I also managed to see former neighbor, Carolyn Humphrey; this was just great. Carolyn and Larry H. were our neighbors, and Larry died during our time in Houston; that was the first loss of someone close to us and I remember it vividly. Carolyn and I caught up on family and friends, and then I returned to Sharon's place and spent a quiet evening with her and Keith, which was lovely. I talked to my mother-in-law the following morning, and that was nice: she gave me an update on everyone. Then it was time to board my return flight, and service was good - nice-looking flight attendants and a piece of chocolate on occasion, life was good.

It is great to see the 3 Weiss men, replete with the joys and challenges they bring. We saw Naren in a play yesterday - a Kevin-Spacey-in-"Usual Suspects" kind of character - and enjoyed it. Navin was in a "Model United Nations" over the weekend and represented Moldova, so educated us about Moldova, the nuclear issue in Iran, etc. Scott and I got away by ourselves to a very extravagant lunch - "you did not eat very much, I feel," our kind waiter said to me. I eat lots of small helpings of things, and tend to feel hungry again a couple of hours later, so a buffet is wasted on me, Scott has determined. But no matter, we went and ate and talked and laughed, and it was very therapeutic: sometimes, the stress of raising teenagers can cause all sorts of wear and tear.

Hope all of you are well.

Unw -

R

Report of 25 Oct 2010

2010-10-25T06:26:00.000-07:00

This is the way to do it.

Wind down at a friend's house, veg, eat good things, rehash memories. A picture of some other friends whom I saw yesterday is up on my camera near me and I am recharged.

This has been an interesting visit. Shortest I've ever had in the U.S. Fundraising has been a mixed bag, as it will be.

However, I managed to see several good people. In San Antonio, I visited with the kids' former pediatrician, Mary George, and that was lovely; Mary has tended to spoil my sons on occasion with Spurs t-shirts and the like, and apologised for not having gifts. Her gift to me was her time, and we laughed and talked and I enjoyed our time together. The following day, she sent a hefty donation to the Banyan through my host and her colleague, David Johnson, to me. So lovely.

The "Conversation with Women Alumni" was nice, and my friend Katharina Hathaway came all the way down from Austin for it. The young students were full of questions for us and that was engaging. It was nice to have Katharina's presence there, she is doing yeoman work as medical director at a center for refugees. I was to have attended a class dinner that night, but came down with food poisoning. I was at a movie - "Red" - just before the soiree, intending to head to it afterwards, but my stomach started to hurt and I could not pay attention to the movie even. As I started to mull over missing the dinner, my stomach made the decision easier by hurting more; so I went to see "Hereafter," a good movie by Clint Eastwood, and then crawled home, getting in bed by 8.45. Linda Johnson kindly checked on me later that night, and the following day, I was well enough to get moving.

Pulling up at reunion breakfast, Emily and Ryan McNellis pulled up also; lovely, lovely. Em promptly handed over a giant sack of clothes for me and we went into the Continuing Medical Education (CME) talks, where Ryan was a panelist. I promptly took a photo - imagine a classmate, young lad, being a panelist! He did well, and then I was summoned outside where Greg Brown was waiting. Greg is also an alumnus, from a later class, and has visited India multiple times. We headed off and he ate breakfast; Greg is a soul-mate kind of person - gentle, funny, kind, cute. I enjoyed the outing. At the b'fast place, we came upon former classmate Jen McKeand and her lovely family: she and husband Chris had had Alec, her son, in 4th year and have since added daughter Lily. Jen was not going to be at any more reunion events, so I was happy to have caught up with her; her sense of humor is very powerful and I laughed almost non-stop for 20 minutes. Jen is also a wonderful OB, and we shared some details of our respective practices, which was nice.

I gave a speech to the alumni at lunchtime, and Emily was kind enough to stay for it. I noticed her head bobbing around others at our table as she craned to see me, and it was an encouraging sight. That experience - speaking - was a mixed bag: all these well-heeled doctors, eating a fabulous meal, and I speaking of the destitute in an atmosphere of little interest (I thought). I returned very despondent to the Johnsons', and then got ready for the glitzy gala; it was nice to see former classmates there. I do remain grateful to our alumni coordinator, David Perryman, and his assistant, Sonia Rogers, for making this trip possible; they are kind and helpful folks, and have worked hard to accommodate me, which I greatly appreciate. Several folks came up to me at the gala and said they'd enjoyed the talk, which mollified me a little. However, the stark reality is that the destitute world will always be one that generates little interest and even lower funds. The only ones who say that money does not matter are those that have plenty of it.

The following day, I left for my friend Latha's place in Houston. Latha and I studied together in Lady Doak College, Madurai, and our families are friends as well. Several years ago, in a horrific accident in India, Latha lost her father and brother while attending the post-funeral formalities of her grandfather. She and I share a bond, and for other reasons as well, it is therapeutic to be with her. We have talked, and walked, and shared, and eaten, and she has managed to fill a part of my spirit that wanted to be filled. She helped arrange a talk in Houston, where I spoke and was happy to see Joycelyn Harris (who used to live in Chennai, and is an extremely "culturally adapting" person) and Mano, a jolly friend from Coimbatore days, and her daughter. It was a nice crowd. Latha and I then went on to visit Bojie, Satchi and their son, Vinod; Bojie is a soul-sharing friend from years ago, looks exactly like my mother, and Latha and I had a spectacular visit with them as Bojie laughed and joked and fed us. Bojie's presence is luminous and all-encompassing. Vinod is our contemporary, and it was nice to share time with him as well. We returned recharged and had dinner with Latha's husband, Ravi, and son Vikash.

I will head to Clear Lake soon to visit my warm and loving friend, Tori, and will share details of that in the next blog. It will be nice to see Tori.

Unw -

R

Report of 22 Oct '10

2010-10-22T08:11:00.000-07:00

Hello from the United States -

Brownies, Blue Bell Homemade Vanilla ice cream, bananas and granola for breakfast - all in the same bowl. Could anything be better? Actually, the sugar ended up becoming a bit much for me, and I had to brush my teeth again.

The week has been busy, but a nice busy. Last weekend was fun, with both boys being available. We saw a Tamil movie and enjoyed it; I like the fact that the boys are becoming much more comfortable with Tamil, and Naren particularly enjoys looking like a white guy in Chennai and spouting fluent Tamil. On Sunday we had a usual family breakfast with healthy stuff and sinful chocolate tarts from Winners Bakery, which trains underprivileged young people in the baking arts. We watched "Pulp Fiction" together, and parts of it were certainly not family fare, but the movie was good for a laugh nonetheless. Our sons shared details of their romantic lives, and this is a privilege for me, that we are trusted with such private information. The boys are indeed becoming men, and Scott and I are preparing for a life when the boys will be on their own, with their loved ones, running their own lives; it's a nice feeling. We visited beloved former neighbors, whose male head of the family died last year; the one year anniversary was observed, and we went to share some times with the family. They are lovely people, and it was Vijayadasami, a day of auspicious beginnings, so it was nice to get their blessings on this day - especially for our sons.

I left for the airport later that night, and had to look back many times - to see the 3 Weiss men standing there and urging me on. I did board, and slept - the seats next to me being empty. The next flight was a bit of a nightmare, unusual for Lufthansa: there was just one choice of meal and then the restrooms ran out of water, which was alarmingly unhygienic in my opinion. I was happy to disembark: the flight took off, stayed in the air and landed, which were the good things that could be said about it. And they are indeed good things. No grief at Houston Immigration, and then my beloved friend, Sharon Cole-Braxton, was waiting outside - beautiful, classy, warm, welcoming - easing all manner of homesickness and jet lag. Keith Braxton awaited us at home, and we shared details of family and life, and Sharon and I walked, and ate dinner. It was a lovely evening.

Sleep that night was heavenly, and then Sharon took me to get my rental car. I left for San Antonio, and landed at the home of Richard and Linda Luduena. It is a home away from home, and Sara Luduena met us for an awesome dinner at a restaurant. The Luduenas are hospitable, fun and funny people, and we laughed a lot over the meal. I worked out the following morning in the cool, non-humid San Antonio air (a change from Chennai), and then did laundry, etc. I got to Greg Freeman's office, where I saw a patient with him, and then he took me to lunch. Greg is a cardiologist of immense ability, and my former professor; as a peer, I have a healthy regard for him and Greg is always kind enough to allow me to accompany him on rounds. We saw an Arab patient, and Greg said he saw many of them; they escape religious persecution apparently, and are helped in the U.S. by many a Christian charity. This patient was my age, and profusely grateful for Greg's mere office visit. I looked at him, and wished him well, and thought to myself that it was very nice to live in a country where I am not persecuted for my religious views, such as they are - non-religious. I take completely for granted the freedom to shoot my mouth off at will, and do feel for those who live in countries that muzzle their citizens.

I saw "The Town" that afternoon and then went to the home of the Freemans, our former neighbors. Aurora and I are like sisters, and her daughters and my sons grew up together; thus, young Shaunessey Freeman's daughter, Vayda - an immensely adorable cutie - is my grand-niece. This is the first time I am seeing her, and she is such a delightful and unflappable baby that I had to hold her as often as others would let me. We had a grand meal, I saw other neighbors Gaby and Lamont and their daughter, Jasmine; this always soothes my soul. I went on to the home of Linda and David Johnson, where I am staying currently. Linda used to be my anatomy professor, mentor, guide, well-wisher, watcher-overer. When Manu passed away, Linda kept close tabs on my sanity and my world. Staying with them recharges my spirit and much else, and I am having a therapeutic visit. I spoke yesterday at school to the American Medical Women's Association, and it was nice to chat with the ladies afterwards. We (Linda; Kozue Shibazaki, the immensely capable counsellor and all-around good person at school, who also kept tabs on my sanity; a former classmate named Katharina Hathaway, who is doing yeoman work with the marginalised in Austin, TX; and I) will be at a "Conversation with Women Alumni" today.

I'd better wind up and get moving. Hope all of you are having fine times yourselves.

Unw -

R

Report of 13 Oct 2010

2010-10-12T23:15:00.000-07:00

This is why we only bite off what we can chew.

Our surgery professor in school, Dr. Carlos Pestana, used to handle a manageable load of topics in our course, and always finished them. This philosophy guides why I work part-time; work and home and marriage and extended family do take up a lot of time and resources, and I cannot do justice to all of them if I work full-time.

The Banyan has been rife with leptospirosis. I have talked to our able store (provisions) supervisor, Balan, and he told me rats and mice are very difficult to eradicate as the building is very old. Balan is a wonderful person - capable, unflappable, our best intentions at heart. He said he did find a rat's nest, and there were 5 babies in it, and he did not have the heart to kill them. But we HAVE to do something about the rodent menace, as it is affecting many of our patients and I need fewer hassles rather than more, in the quest to provide care to the marginalised.

We have rescued a patient from the streets, and her leg wounds are healing. They had been full of maggots, and the surgeons managed to save her limbs in spite of this. Her spirit is good, and she speaks of some relative or the other doing black magic and jeopardising her health. She also speaks some English, telling me to sit down as I stand during rounds, and telling me to eat, at lunch time. I am always moved - MOVED - by such consideration, especially from those who have been abandoned and brutalised and should really lose all faith in humanity.

One of our health care workers (hcw's), Ms. U, had her braces removed and her teeth are straighter. As I complimented her on them, I noticed that her glee was less than full. As she left the sick room, the hcw in charge of the sick room told me that both Ms. U's older sister and brother had died; her sister had committed suicide and less than a month later, her brother had died of a brain bleed. I was stricken, and called Ms. U back; I mentioned how sorry I was, held her hand, and then her shaking shoulder as she wept, and wept. Losing a sibling is always an unexpected jolt in one's world, and losing two - ohhh, I can not imagine. So, we commiserated on our older brothers' passing, and I told her that she and I must now take care of the widows and nieces and nephews, and we grieved together.

My father was in town last week and we managed to see him for a couple of hours. That was nice. He is learning to reconnect with his children - this always having been my mother's territory - and converses on topics other than plastic surgery. I am glad he feels free enough to come to my home, though his colleague had told him that he could not go to his daughter's house; in traditional Tamilian culture, you only go to a married daughter's house if invited (as she is now considered part of another family), whereas your son's house is your territory. We are far from traditional, so my father came to our house and we received him happily.

Sundaram Medical Foundation's annual conference was this past weekend and I was there with bells on. It is annually an excellent show and the opportunity to learn is so welcome. The bane of many an Indian event is lack of punctuality, and SMF has this down to a science: they start on time and buzz their speakers if they run over their allotted 20 minutes. Very lovely; so learning proceeds at a swift, engaging clip. Dr. Arjun, the director of SMF, and Dr. Suresh, organising secretary, are good people and it was nice to talk to them; they render yeoman service to the B. The evening event featured a speaker on mental health, and Scott and I went and had a good time, finishing the evening with a lovely dinner.

The boys are well, and we will have both with us this weekend for some rare family time before I leave. We will see a Tamil movie, I think, and play a board game, and eat some dreadful pudding which I make with regularity, and which all (except I) inhale. Simple joys, but all part of being a wife and mother.

Unw -

R

Report of 4 Oct 2010

2010-10-03T22:34:00.001-07:00

This is exhausting.

I am trying to find a venue to speak in Houston on 24 Oct, and am drawing a blank. The needs are a wall, a computer with Powerpoint and a projector. No luck so far.

Uthscsa, my alma mater, is paying for me to attend the reunion and speak there. Halleluia! I am delighted, because the Continuing Medical Education program I was eagerly awaiting is *this* weekend, and the reunion is on the 22nd-23rd. So I get to go, and speak, and was wanting another venue in Houston. It gets awkward for me to push the issue; I don't pass the hat at speeches, but most people fear the worst. Anyhoo, que sera sera.

The patients have been healing, though the incidence of gastroenteritis is on the increase. A couple of weeks ago, I had it too, and sort of thought the B's food was the culprit. Leptospirosis is also on the increase and we have to find the darn rodent and eliminate it - lepto is transmitted by rats. One of our older patients was looking very puny the other day, and when we checked her BP, saw that it was low. She's recovering from an upset stomach, and we started IV fluids, which appear to have worked. The older patients have very little reserve to survive an attack of diarrhea, same as little people, and I view this rampant gastroenteritis as a personal failure. Leela, our able nurse, suspects that the ladies are drinking from the taps, which we never do in India. Leela has instituted some measures to try and stem this problem, and I am hopeful of results.

Ms. V, our patient who gets delighted at all relatives' visits, got to talk to our cook's son the other day. He (the cook) had brought the boy to be checked by me (I am not a pedatrician by any stretch, but that does not appear to matter), as he was worried the child was a tad slow, especially compared to his younger sister. I did not find the child slow at all, merely contemplative and quiet, and mentioned that comparisons between kids should not really happen. The cook was a tad mollified by that, and took the boy over to the sick room to be weighed, at which point Ms. V saw him and was delighted by the visitor. I do wish more of our patients' relatives visited.

I had to refer the cook's brother over to Anu's institution; the diagnosis was suspected hepatitis, but that was ruled out. A scalding poultice has been applied to the young man's arm by a local mendicant, and as always, the burn is a bigger problem than the hepatitis. It is nice to know resources we can refer our patients to. The other day, the owner of the salon where I get my hair ironed on occasion mentioned that a friend of hers had her hands full with her daughter's depression; a phone call to Vandana later, the lady had an option for help.

It is oh-so nice to try and be of help to others, and connect people and resources.

Some fine times last week; we saw a beach volleyball tournament featuring teams from several countries and the quality of play was very good. I love live sports, and both Scott and I could get past the little bikinis on the female players to watch the actual play; the average repressed Indian male could not, however, and we were surrounded by men who were there for 1 reason only. We also saw a dance performance from Brazil; it is nice to see dances of other nations, and this one was good for a while. Bare-bodied men, attractive women, all oozing raw sexuality and dancing to the music - and then the acts got very repetitive, so we left. At one point in my younger days, I attended a friend's bachelorette party at a male strip club and enjoyed the novelty of the first 2 acts, then hoped fervently that the subsequent ones would juggle or tell jokes; just stripping and dancing was monotonous. Yesterday, Naren and a friend came for lunch, and that was a blast. I like interacting with young people, and young Nicole Norton in Indy was a particular treat - feisty, opinionated, genial. This friend of Naren's is an actor and has been selected to represent India at a 3-month theatre workshop in South Korea. Naren and he love each other dearly, in the manner of a healthy friendship, and we are always reassured when our sons pick good people as friends. After lunch, these 2 young guys dropped Navin at a nearby art gallery which had a showing of work by underprivileged girls; I would have loved to go, but grabbed the chance to watch "The Hurt Locker" with Scott, and we enjoyed our time together. It was better for Navin to go by himself, as he coincidentally met friends there, and they appreciated the art with the young, tender hearts that teenagers have; better this way than for him to see me wiping tears at the show and perforce seeing the effect that underprivileged folks have on his family.

Some grand news last week: Leela reconciled with her brother after many years of silence. Her sister-in-law helped bring this about, and I am very pleased. No point to not talking at all, especially to family members. I am especially appreciative of the sister-in-law's efforts, as I know of families where it is the spouse who foments the acrimony and prevents all efforts at reconciliation: pointless, wasteful and malignant, in my view. I was happy for Leela, who feels that prayers have been answered. That thought echoed in my head as Anu stopped by last week, and we had some giggles.

Unw -

R

Report of 27 Sept '10

2010-09-26T22:55:00.000-07:00

Hello folks -

A busy weekend ends, a hectic week starts.

We are well, and hope the same with you. The Banyan has been great. I wish to extend an apology to you: when I mentioned the patient, Ms. S, dying last week, I went on to discuss the repercussions of her death. At no point did I voice sadness at her passing, and I am sorry. I was indeed sad at her passing, as I am sad at all deaths at the B. However, I am happy that Vandana and Vaishnavi founded the B, so that we could give a home to Ms. S and she could die surrounded by love and caring, instead of on the streets - alone and unkempt and in pain and miserable.

We have a patient rescued recently from the streets: Ms. Se has had some nausea and vomiting, and is also found to have leptospirosis. She was treated, and got better, and has been scrubbing the sick room spotless. Many of these women are used to running families, and so, cleaning and cooking and caring for someone else is second nature. Ms. Se is young, very attractive and was found semi-naked on the streets. She is HIV+, and is under follow-up for the same. One day, I asked what she had eaten for breakfast - the reply clues me in to all manner of conditions: dementia, forgetfulness, loss of appetite, state of mind. We (the Banyan) had had dosais, a flat bread made of rice batter. Ms. Se could not quite get the name of it, as she is North Indian and this is a South Indian dish, and I smiled; we met each other's eyes, and Ms. Se had a look of such innocence in her as she sought the name of the dish that the interaction was pure and fun for me. I told the Weiss men that we cannot assume Ms. Se contracted HIV through rape, as she is young enough to enjoy intimacy. Whatever the circumstances, we will treat Ms. Se and work to rehabilitate her.

The B's flat broke state continues. It is like pouring water in a sieve.

The weekend was busy also. Naren was in an intercollegiate play competition, which evaluates plays and the colleges' efforts to sell tickets, and Scott and I went to see the competition over 2 days. MCC had won "Best Play" and "Best Director" last year, and was expected to do well this year. Naren's friend, Ujjwal, a multi-talented and humble young man, wrote the play this year and it was brilliant. Unfortunately, the cast sank it - they were inaudible and did not revel in their roles, and I was furious. I have apologised to Ujjwal and have asked for my money back from Naren. A women's college named Stella Maris stole the show with some stellar marketing, targeting part of their profits towards transcribing textbooks to audiotapes for visually impaired high school students, and an excellent play. You go, girls!

Navin's exam grades came back, given at a Parent-Teacher meeting. As I told him, I have attended P-T meetings for about 14 years now, and if ever I heard, "He's done very well, and has realised his potential," I would faint and need to be resuscitated. It's always, "Can do better." Navin shaved his head yesterday, prayed to his grandmother's spirit and will attempt to apply himself henceforth.

Ahhh, the joys of raising teenagers.

Through all of this, however, I am grateful that the family is together and communicating. So many people do not have such good fortune.

I spoke to my father and he is doing well. He asked that I phone again, which I found very sweet.

Unw -

R

Report of 20 Sept 2010

2010-09-19T22:53:00.000-07:00

Hello from the B -

If this is how busy life can be, while working part-time, I wonder at full-time.

Work has been frenetic. The Sir Ratan Tata Trust, our major funders, had their audit team come to check us over. We are a transparent organisation, and everyone can look at whatever they want. The 2 auditors who came, VG and BG, were young and at least one was a physician. Neither was adversarial, and wanted us to think of various things, and figure out how to get our reports to conform to their specs, etc. They were very, very sharp, and it was a joy to listen to them. An older advisor to the team, a psychiatrist, was somewhat combative, and he had several questions for me as the medical director: "Can you provide some proof that your training the health care workers (hcw's) has helped?" Serendipitously, that very morning, we'd had an emergency: Ms. S, our deaf mute patient, had had an attack of diarrhea, and then been found unresponsive, cold, clammy and pulseless. We'd resuscitated her and sent her on to the hospital. I narrated this incident, with very real and concrete proof of how well the hcw's responded, and there were no questions to the medical world after that, for that day. I had "run the code," i.e., medically led the resuscitation, but did not mention that. ("That does not matter," said my kind husband.)

The next day, the same combative advisor went on to say that primary care practitioners ought to diagnose and treat mental illnesses, there were training programs for the purpose, shortage of psychiatrists, etc. I do feel sorry at the shortage of psychiatrists, but I find this viewpoint unrealistic and arrogant, as I have absolutely no interest in psychiatry. I mentioned this, and the exchange was not pleasant; Vandana has, however, faced this exact issue in some other providers and so, this point of view is not new to her. Especially not from me: when she hired me, I told her I had absolutely no interest in mental illness and she was cool with that.

The lady with the broken arm, the one who had struck me as having once been a wife and mother, has died. She had surgery to fix the arm, and then her stomach bloated, and a day later, she died. I have no idea why, and again, feel completely deprived of valuable knowledge. Even in death, patients can continue to educate. We cannot request a post-mortem here without casting blame on someone, and that course of action is not available to us, so I have to shut up and "s--- it up." Sigh. I could use the information toward other purposes, such as prevention. A couple of years ago, some of our mentally challenged (not mentally ill) patients died suddenly, and I still have no idea why. I discussed this issue with Dr. Greg Freeman, eminent cardiologist who taught us in med school, and he had some ideas which I am implementing here.

I am always grateful for the mentor-ship of my wonderful former professors. Many continue to keep in touch with me, and I am richer for it.

Ms. S, our genial, deaf, mute patient, is apparently better after her bout of unresponsiveness. They kept her in the hospital for more tests, and I was grateful: why did a young, apparently healthy woman get this ill after 2 episodes of diarrhea? I am anxious to see the test results. This hospital, Sundaram Medical Foundation, or SMF, does a great job with our patients, and indeed, all patients. Scott had his surgery there 3 years ago, and we were pleased with the care, and the reasonable bill.

There were other responsibilities: neighbors wanted to see me, relatives wanted to get together, there were friends to call, and *plenty* of patients to see away from organised environments. I am not a big fan of the phone, but tried to keep up with phone responsibilities. On Saturday, Scott and I drove to Bangalore to see my widowed sister-in-law, Susan, and niece, Sanjana. Nephew, Sudhir, had to work, so we did not see him. It was good to see Susan: she is a warm, genial, loving sort and we had a great visit. She is always grateful for gifts that I bring her/them, and this time was no exception - little cologne, chocolate, etc., went over well. She had biryani (rice pilaf, with either meat or veges) for us, and that is one of my favorite foods, so I overate merrily; Susan packed leftovers for us, too (I told you she was warm and loving, let's add "generous" to that list), and I had some of those in the car before we left Bangalore city limits :). Sanjana is 12 and at that stage of growing up - where she wants to try wearing plunging necklines, etc. Boggles my mind. It is far easier, in that respect, to raise boys. I have wondered if one boy's shorts will end up around his ankles at some point, but there is usually underwear under the shorts.

It was nice to go on a road trip with Scott, and though tiring, we had our "Book of Questions" along. The questions are thought-provoking and fun, and often provide insight into each other that we would not normally get. "Have you ever walked out of a movie because it was so bad?" Once. Tamil movie, Dasavatharam. Otherwise I stay until the bitter end, even for stinkers like "Catwoman." "Hey, that was a classic in its field," said Scott. "Which field would that be?," I asked, and he laughed and said, "T and A." I did not know this phrase until a couple of years ago, and it sure fits the movie: "T--s and A--" (female attributes).

Craig called from the U.S. at the end of our trip. That was nice. Phone calls from the U.S. are rare, and I was happy for Scott that he got to talk to our irreverent, funny, witty, insightful friend. We celebrated Scott's b'day yesterday, and the whole family went out for breakfast (sausages and eggs - ooooh) and a couple of Tamil movies; it was great that all could go. Dinner was also outside, and our favorite waiter produced an extra chocolate mousse as a gift for me, and I told him the occasion, passing on the gift to Scott. The waiter's was a nice gesture, and the day, spent with the men, was fun and good and full of bonhomie and laughter - likely a direct gift from above. Naren said things like, "When I was drunk once," and as my eyes widened, I did feel happy at the candor nonetheless. Navin said my incessant message of "NSBM" - No sex before marriage - tended to come out at weird times, and that he had shared this with his friends. I had cried at a couple of points in the movies - for instance, when a boy educated in the Tamil medium had felt out of place at his big, fancy college; the men laughed and said, "Yep, Amma would weep at the opening credits." It was funny.

So, I just had to weep again, in secret. Ms. K and Ms. M are a child-mother team rescued from the streets by the Banyan years ago; Ms. K finished grade 12 this year, and is in college! One of the best colleges in the city, Ethiraj, and studying history. She is visually challenged, and the field work in psychology, her favored subject, would have been difficult, so the college suggested history and Ms. K is enjoying it and dorm life. I am delighted that she is moving along! Usha and Grahalakshmi, my colleagues, just mentioned this update, and Suresh, another colleague, whipped out the newspaper article about Ms. K, and I read it, and wiped the tears, and felt exceedingly happy at this news.

My good colleague, Gayathri, is taking 2 of the patients out for lunch and the 2 are so excited, especially as it is now time for them to go. It is nice when our mentally ill and marginalised are not marginalised.

Such a great organisation to work for, such a good life.

Unw -

R

Report of 13 Sept '10

2010-09-12T23:10:00.000-07:00

Hello from the B -

The main is supposed to be switched off as some electricity work needs to be done, but there has been no follow-up instruction and I was told to continue working for now; so I am typing rabidly until the electricity must go off. To add to the chaos, the B's website is listed an attack site, preventing all from accessing it - oh joy.

Work at the B started in full swing, and it has been nice. One of our patients, Ms. V, talked of her mother admitting her to the B and taking off; Ms. V will be with us permanently. One day, another patient's very cute mother, Ms. A, came to visit; Ms. A is around 80, about half my height, with completely white, close-cropped hair (she likely shaved her head at a temple) and a very, very loquacious manner. She must have reminded Ms. V of her own grandmother, as Ms. V went up to her and said, very tenderly, "Ayah," which can mean "grandmother." Ms. A included Ms. V in her jolly chatter, talked of how many buses she took to get to us, and genially asked Ms. V if she was keeping well. Ms. V had started, earlier, to get belligerent on occasion, and all that fled when she saw Ms. A. It was wonderful to watch, that we could make someone so happy by another's relative's visit.

I wish all the Banyan residents had family visiting; it truly buoys up the residents, unlike anything we could ever do. But family has often abandoned our residents. As I looked at one of our patients, who has a broken arm, I thought to myself that she was, at one time, active in her role as wife and mother, and likely loved it; as soon as mental illness struck, she was then dispatched. Out of sight, out of mind. When I reeled under some weirdness after both kids were born, calling Scott one evening to come home quickly as I needed a break, he hastened home and that let me head off and walk. A few years later, a young mother in the *same neighborhood in Houston* killed all 5 of her children, likely in part because she did not have the same support.

Our deaf, mute patient, Ms. S, gestured to me that she had felt feverish and had body aches. So, I ordered some blood tests and there it was - leptospirosis. I have started treatment, and hope she feels better. Ms. S rarely misses work, but when she said she could not go the other day, we knew something was up. Ms. S has also asked for a hearing aid; she was evaluated by ENT, who has determined that Ms. S's hearing loss is congenital and would not benefit at all from a hearing aid. Woe. I have tried to explain this to Ms. S, with varying success. She also would like her home traced, as there is a little person waiting for his/her mother, but we have no way of doing that if Ms. S cannot communicate her home address or at least landmarks. Let us see - we are a "Do or die" organisation and we might involve TV channels if we need to.

So much to do, not all of it medicine, but somewhat healing, nonetheless.

We drove to Madurai over the weekend to see my father, and that was nice. He has to do a lot of the grocery planning himself now, and does well enough. He is also extremely active in the hospital, and as part of the Board of my alma mater, Lady Doak College. So he was gone for meetings ad infinitum when we were there, which might have po'd my siblings off, but I like the fact that he is busy. I'd bought him a Ralph Lauren suit jacket in the U.S., shopping ably aided by Colleen Taber; my Dad had asked for a jacket, and I spent much more than I normally do on anything. But what the heck, he is my father, and he quite liked the sharp jacket. It was nice to be home; my mother's presence so infuses every elegant room of that house that it does not feel like she has gone. It was also nice to take a trip with the boys: they are great company, and like getting together with their relatives, to our relief. We also saw Mrs. Kurien, a loving friend, and all 4 of us loved that, also; she had made the boys' favorite treat, banana paniyaaram (fritters), and the boys ate 2 plates-ful.

Our (my father's) cook has married and returned with her groom to live in the little house behind my parents' house, and we met the young man; he's nice. The day we left, he asked to talk to us and when we went down, he thanked us for "giving him a life," that he never expected to get such a nice wife, etc., and got very teary; he has a mild skin disorder, and all the young women proposed for him before our cook had vetoed the connection. Ms. A, our cook, was sent to work when she was 10 years old and her parents have since lived off her, and abused her, and stolen her assets; well, all that is at a stop now, and that's great. My mother apparently suspected that Ms. A was not her parents' biological child, that she was abducted from another family; my mother could not envision a daughter being treated the way Ms. A was by her parents.

It is wonderful when good things happen to good people.

Anu and Benji stopped by our house yesterday, to our delight. I know of families where sisters will not stop by. Anu brought me 2 pretty bracelets that she'd bought in Israel and she is wonderfully sweet that way: I have items from South Africa, and the Philippines, and the U.K., and other places that she heads to. The Perakaths were heading separately to see the play "Jesus Christ Superstar," as were we, and we met up at the theater again. The play had very good singing, but the production itself was a little bogus - the guards held guns, and several members of the cast wore street clothes circa 2010. Scott and I had had a day to ourselves, as both kids were off doing other things, and we *totally* enjoyed the day; in fact, when Naren had wanted to hang around in the morning and listen to our "Jesus C. S." cd, we had requested that he head off on his social outings sooner. :) Scott and I managed to see, on DVD, "Monkey Business," and loved the Cary Grant-Ginger Rogers-Marilyn Monroe flick. At one point in his 20's, Scott had visited his aunt in Oregon while there on business, and when I had mentioned it to my aunt, she said that boded well for *our* family life; indeed, it has - a young man or woman who is close to his or her family will inevitably run a good show when it comes time for marriage and kids. It is nice to realise that.

My University of Texas Health Science Center at San Antonio med school class will hold its 10th year reunion next month, and I so wish I could attend; all 4 of us have the best memories of school, meeting some lovely people and having neighbors who are still like family. However, finances preclude this, and it is when I travel (or don't travel :) ) that I acutely feel the lack of bucks. One of the best continuing medical education sessions happens in Chennai that weekend, so there are compensations for not going to San Antonio.

Okay, enough chatter. The Banyan is flat broke as usual, and I am going to have to see about getting meal sponsors. No luck so far, but hope springs eternal.

Unw -

R

Report of 5 Sept 2010

2010-09-05T00:55:00.001-07:00

Hello from my bright living room -

Scott is asleep on the floor, laundry dries on the balcony, 1 boy is off being tutored for an exam tomorrow, and 1 boy has gone to attend a play. Jet lag is squeezing sleep into all my pores, but I am trying to stay awake for a little bit.

Settling back into the routine is easy. This morning, I woke Navin up and told him to go run, and he started laughing. Then, "Are you serious?" I was. I had worked out, using several exercises from boot camp, and felt good and invigorated. Clearly, no one else shared my love of the early morning hours, hugging their pillows and writing letters to Kumbakarna (our equivalent of Rip Van Winkle). But off Navin went.

I saw patients until the day before I left, and one of them was a young man of Mexican descent who was being evaluated for kidney failure. He, his wifeand children come up to Indiana every summer from Texas to work for Red Gold tomatoes, and neither adult has health insurance. We have had to extend charity care, but my bigger focus is on coming to the reason, or "etiology," of his kidney failure, which was discovered in Indy. The couple had several questions for me, and I had a lot of time for them, so we went over everything in great detail until the wife was satisfied that all queries had been answered; she was naturally unnerved by what was happening, and I empathised completely, giving her a hug at the end of the visit, and wishing both of them well. I will be curious to see the results of all the blood tests.

There were a couple of fine times before I left the U.S. Shilpa and Ravi Mallur and their kids came over to Colleen's, and we spent a lot of time talking, and playing with the kids; it was an idyllic evening. The following day, we ate leftovers at work - there had been a lovely lunch the previous day, including a very delicious Becky Lewis cake, which I had a piece of for breakfast. I was privileged to get phone calls from Ruth Smith, the former CEO of a clinic I'd worked at, and a very visionary doctor - we chatted and laughed and discussed work and family, all of which was lovely; from Monica Cooley, who taught me ballet at Lady Doak when I was 16, and whose friendship, solid perspective and sense of humor I have valued greatly; from Linda Johnson, my anatomy professor in med school, who knows my family well and considers us part of hers - we talk of several things, not just medicine, and laugh a lot. I had patients to see, and then an exit interview with Bruce Haga, the vice president of the organisation I work for. Bruce is very down to earth, grand fun to talk to, and we laughed as we discussed our respective 2 sons, and life, and working environments and by the way got to the feedback session. Bruce's assistant, Debbie Prier, had escorted me to the venue of the meeting, and I enjoy talking to Debbie as well; she is personable and warm and her eyes laugh when she does. After finishing there, I had some last-minute shopping to do, returned my rental car, Colleen picked me up, and took me to dinner with Mark and Christopher. All 4 Tabers have Mensa-quality IQ, and I loved the discussion on various topics over dinner. Christopher, in particular, has extremely insightful opinions and I love, *love* this kid and his sister, Melinda. I packed, and repacked, and had to throw; we ended up leaving later than expected on Thursday for O'Hare, after picking up some precious movies that Gabe Soukup and Kris Rea had ready for me - that was nice of them. Colleen was very patient with me as I did things at the last minute, including stopping by the post office. However, we made it to O'Hare on time and there was no line at all at the Lufthansa check-in.

I reached safely, and after a solid 8+ hours of sleep, Scott and I went to attend Harini's wedding festivities. Harini is an occupational therapist at the Banyan, and is of considerable calibre, and a very warm and wonderful spirit. I was exceedingly happy that her fiance, Sriram, seemed like a nice person, and both Scott and I were pleased to share in the merriment.

I also told my father of my safe return and he said, "Welcome to India." I think we will see him next weekend.

Last evening, after dinner, we discussed the boys' shenanigans. Naren had checked himself out of the dormand found himself a place outside, paying for it himself and not telling anyone until he told me last week. Navin's grades have not been optimal and that will not fly here - not in India and not with either of his parents. Both boys informed us that it is sometimes difficult to talk to us, because if they tell us of their stunts, they get punished; we countered that we always appreciate the boys' candor but that sub-par thinking will merit consequences. At various points, I yelled and cussed, and cried once; Scott stayed calm and presented his disappointment with gentle words and a mild tone. Naren said it (Scott's message) was powerful. Navin, who has mulled over law school, presented his brother's case eloquently, and it was distractedly nice to listen to 2 opinionated young men talk to us about their views. We finished up, with everyone appreciating the openness of the discussions, hugged with a lot of love, and went to bed.

It is nice to be home. I hope you have similar joys.

Unw -

R

Report of 31 Aug 2010

2010-08-31T08:37:00.000-07:00

Hello from the U.S. -

Life has been frenetic - with work, shopping, packing, throwing, etc. But it's all good. The patients, in particular, have offered a variety of cases.

Mr. X, the cancer patient, has died. It happened a lot quicker than I anticipated, and I wanted to go to the funeral, but there were no details as of the end of last week. I liked his spirit, especially being feisty enough to pull a shotgun at people. One of my beloved cousins has a daughter who was diagnosed with leukemia when she was 3 (some years ago), and the family went from Coorg to Bangalore for treatment; when I talked (from the U.S.) to my cousin there, he gave me an update, and then said remorsefully about his daughter, T, "She does not behave, she gets angry when the nurses and doctors come in to draw blood, and hits and kicks and bites." I was delighted, and said so: this is exactly the spirit we want our cancer patients to have, instead of rolling over and letting the diagnosis take over. Thankfully, knock on wood, T's cancer is in remission. And her spirit sails on.

There was another patient, a young student from a prestigious engineering school, who brought 2 pages of typed asthma symptoms. Her mother came with her, extolled the virtues of her singing, tennis playing, very bright daughter, and they offered an exhaustive account of these symptoms. It was annoying; more so because I did not feel well, had had some surprising news from home, and was not up to listening to some treatise. The mother also stated that the daughter had enough credits to be at a higher level than she was; I understood none of this, as I did not go to undergraduate college in the U.S., except that the info was said to draw some ooh's and aah's, which were provided (right along with the thought of "Why the **** do I need to know this?"). Lung and ENT evaluations were already set up and I suggested a psychiatry eval for the patient's anxiety; thanfully, the pair did not balk at it.

Some fine times last week: I got together with Cindy Belloli and a bunch of her female friends for dinner. It was a great time, with some luscious finger foods, and all of us ate and talked and laughed. Faith discussions at the Nortons' place wound up, and we were privileged to have Traci join us. I have enjoyed these discussions, and have asked all the questions I wanted to. As I looked around, I noticed that all the Mormons gathered were extremely nice-looking: all this clean living sure manifests on the outside, doesn't it. Theresa Jefferson and I had lunch on Thursday as she took a break at work, and that was as lovely as always; Theresa's perspective, sense of humor, love of life and family are all inspirational and fun. We talked endlessly, or as much as we could fit in 45 minutes. Kris, Gabe, Isabella and Rosalia made time in their busy schedule to have me over for pizza, and I revelled in their company. I love, *love* these folks and enjoyed my time there. On Saturday, Colleen and I met up with several St. V colleagues for a Beatles concert; it took us 2 hours to go about 7 miles to the venue, but the show was outstanding and Sister Rosie, who just turned 80, and I danced to "Twist and Shout." Deb Rasper, the St. V Mercy CEO, again put on a terrific time - with a potluck meal and tix to this event. Carolyn Scanlan and I met for dinner on Sunday, and it was wonderful to catch up with this friend and share her sense of humor and ebullient spirit. I have always been impressed by her ministering skills, and she is the reason I started going to church for a time. Colleen and I managed to talk for a bit, and it was lovely to sit in their beautiful backyard and gab; she also helped me shop, which I always appreciate. Sid and I met for a wrap-up session yesterday and it was nice to talk and listen to his remarkable perspective. I got to talk to Hema, who operates Friends of the Banyan for us in the U.S., and it is like talking to a sister - loads of affection, and good humor, and the best of wishes. Yesterday, there was a gorgeous Debbie-Weaver-made cake at Alexandria, which I had 2 pieces of, and plenty of farewell hugs. I chatted with Dr. Love this morning, and he was kind to address my umpteen medical and faith questions. Today, I have had a wonderful lunch with Elwood colleagues, and got loaded down with beautiful gifts to take home. Lots of memories.

Boot Camp wrapped up last week, and stayed clean. It was an exemplary workout, and I enjoyed it immensely. I appreciated even more that it stayed clean.

Naren and Navin have been up to some merriment at home, and their father has been stretched a bit to handle both. It really is time for me to go, isn't it - to handle things as a couple, and as parents, to hug and love and talk and laugh. I was 100 times worse as a teenager, so will try to discuss these young folks' shenanigans with that perspective - but don't bet on it. :)

Unw -

R

Report of 23 Aug 2010

2010-08-23T12:43:00.000-07:00

Hello from Indiana -

Hope the week has been good.

I got some spectacular news last week. Ms. X, the patient I have mentioned before as being very kind to the young Indian neighbor, had come in with her husband, also a patient, some weeks ago. Mr. X had coughed up blood, and had a lung mass seen on CT, and I feared the worst, i.e., cancer. So I sent them to a lung doctor, who looked at Mr. X's lungs through a special instrument, and determined that he did not have cancer. Hooray! Ms. X told me she had called and left a message for me as soon as she heard the lung doctor's news: "I knew you would be worried." I found this extraordinarily sweet, and though I did not get the message, I appreciated her gesture, and more so, I appreciated enormously the news about Mr. X.

Good things do happen to good people.

Ms. X also brought me 2 jars of apple butter and 1 jar of tomatoes, all of which she had canned herself. So wonderfully kind and generous.

Some fine times last week. My salsa class wound up. A few people from the Y and I got together for Mexican food. Natalie, Chris, Cara and I do Boot Camp together, and Amy and all of us spin together. It was a nice evening, spent gabbing and eating, and these are fine folks to do this with. A diner from another table stopped at ours as he was leaving, and asked Chris (who generously treated all of us to dinner) how he could be sitting with 4 women; Chris answered, "I used to be one," (not true) and it was funny. On Friday, my colleague, Beth Prusinski, had all of us over for lunch and it was fabulous. It was nice to spend some time gabbing over great food with colleagues, and Beth's Mom was there, too, which made for a fun time; I love meeting parents. We sat in Beth's beautiful house and had a great view of their yard as we ate. Friday evening was spent talking with my hostess, Mary Beth Simon, and sharing her unique sense of humor and unflappable perspective; that was nice. I spent part of Saturday at the farm with in-laws, and was fortunate to see Scott's Mom, aunt, uncle, an aunt visiting from Oregon, and both my sisters-in-law, Diane and Karen, and Karen's partner; Scott's grandparents stopped by briefly. The in-laws are a fun bunch, I love them dearly, and I had a very nice afternoon. I then joined the St. V Elwood hospital (Mercy) crowd for an open air concert at Conner Prairie, to hear Duke Ellington's band. Mercy's CEO is Deb Rasper, and she does a great job as many female CEO's are wont to do. I enjoyed talking with Deb and her husband, and partook of some sinful dessert. On Sunday, I had lunch with Mary Remster and her son, Donnie; Mary and I volunteered at Special Olympics many moons ago and have stayed in touch since, to my great delight. The food and company were spectacular. As they were at dinner with the Sparzos; it was nice to eat scrumptious food, talk and spend a pleasant evening on their porch.

Boot Camp ended up becoming a bit weird with innuendos about the milk jugs we run with, a student sticking out her rear end toward the (male) instructor and the man patting it. I found all of it singularly inappropriate, and after the workout, said so to him. He said that he and several students had known each other socially for years; he did say that it was difficult to remember the line between social and Boot Camp. I noticed that he tried to stay clear of the innuendo today, and appreciated that. Several students revel in the raunchy, and it gets uncomfortable. The cosmos does align itself; this is the part of the U.S. that I don't quite like - the tremendous obsession with all things sexual - and the message is very clear, broadcast to me every Boot Camp morning, that it is time to go.

I spoke to most of the men in my immediate circle - my Dad and 2 Weiss men, and that was nice. The other one did not pick up the cell phone and might have been asleep.

The Tabers' warm, cozy, hospitable home is my current location, and the warm, hospitable Tabers are as comfortable to be with as ever.

I saw "The Switch" over the weekend and it was surprisingly good.

Unw -

R

Report of 17 Aug 2010

2010-08-17T07:10:00.001-07:00

Hello to all -

Hope everyone is well and enjoying the gift of good health.

Work has been fun. I am off crutches and am thankfully well enough to see the tons of patients that come in. The day flies by, and soon I am driving back "home" after 5 PM, listening to Lady Gaga or Dire Straits. One of the patients who came yesterday was reeling under a migraine. I could not give her the usual migraine meds as she has a heart condition, and I was hard-pressed for other choices. I did suggest that the patient see her dentist, too, because my able dentist, Dr. Scott Prusinski, said sometimes tooth problems can cause a headache, and I wanted to rule out all other pathology in my patient. She did not feel good at all, and did not answer my questions directly or to the point; this got a tad frustrating after a while, and I pulled my stool closer to the patient and said, "I am not sure if I am not making my questions comprehensible, or whether it's my accent, or something else, but I am not getting clear answers to my questions, so let me try again as it is my responsibility to get the information I need." I had to go after the answers, and thought I was getting on the patient's nerves, because she was in so much pain she actually was in tears at points of the interview and I felt awful. At the end of the visit, though, she did very sweetly thank me for being thorough, and her husband said my accent was not an issue. Very kind, I thought, on both their parts. Our capable medical assistant checked on the patient this morning, and she is a bit better; apparently her husband remarked on her looking better, too. Halleluia.

I work with some magnificent folks, I assure you.

After such genuine patients, it was easy to tell the young woman who had a chest piercing (screwed in, has to be surgically removed if she wants it out), and had been released from rehab for alcohol and sedative addiction, that I could not give her Vicodin. We had a clear note from the rehab facility not to give her narcotics, and I said so, and the lady got irate, and said, "Who are they to tell you what to do? God?!" I suggested she take it up with the facility, walked her out, did not charge her for the visit, and went on to my next patient.

We saw a patient last week, walked up from the ER by the ER doc; Mr. X has lung cancer which has spread to the liver. I talked at length to Mr. X, and set up Hospice for him, figuring he'd need some attention at home and could avoid going to the ER. There was a note for me yesterday, saying Hospice had gone to Mr. X's home, and he had come out with a loaded shotgun, threatening to fire it and saying he wanted to work some more. I laughed; I'll check with Mr. X when I see him next what his understanding of Hospice is.

Naren's foot is swollen, I changed his antibiotics over the phone and he has been ferried to class by Scott, thank goodness. Navin was cramming for a test, and I said, "Good plan, yeah, to study for a test?," and he chuckled. I love hearing this sound from the men. My nephew, Sudhir (Manu's son), is visiting in Chennai, and I truly like the fact that this nice young man feels at home in our house and that he and our sons have a blast hanging out together. Scott is managing everyone well, and it is time to go home and join the party. Nothing like hearing that a child is ill to bring out the Mother persona and micromanaging tendencies.

Some fine times last week - I spoke to Sudha Swaminathan, a dear friend from Madurai days now living and working in Connecticut, and liked that; it's nice to chat of home and now. I joined Mandy and John Sparzo, and some of their friends, to listen to a band. I danced at the venue, and revelled in that; dancing is truly a life force for me. I saw "Eat, Pray, Love" and it was horrible; Javier Bardem managed to salvage a bit of the movie, and not just by his looks, either. Colleen Taber, Sonia and Anna Inger, and I went to the Indiana State Fair, and enjoyed each other's company immensely; I joined my salsa instructors, Dean and Audrey, for a demo at a "Dance for Health" stage. It was great fun, as my partner (Audrey's husband, Brent) was a very competent leader and I find it easy to follow steps when the lead is so good. On Sunday, I had breakfast with Tamela Horkay, Ruth Ranalletta, Boni Hypes, Beth Hartauer and one of their friends, Monica; it was a rejuvenating time with good female friends and tasty food, and we ate and laughed a lot. I attended the Indians baseball game, tix given by St. V, and had a great time - I enjoy live sports. I did not sit at my assigned seat, as it was too hot, but stood in the shade and ended up talking to a very personable young woman sitting nearby; she is undergoing treatment for uterine cancer, and we talked of it, her good doctor, Rob Manges (also a friend of mine), our sons, and husbands, and life, and all of it was lovely. I admired this lady's courage, and love of sports. That night, I met Louise Hass for dinner. Louise is an extraordinarily intelligent lady, and is widely travelled; her sense of humor, solid perspective, love of life and witty conversation serve to make each meeting memorable. She has lost her son, I have lost my mother and brother, and we talk of life, love and loss; all very therapeutic. Sid Norton continues to host discussions on faith at his house, and Sister Esplin and Sister Humpherys join Sid in being very patient as I muck around in my confused state. The discussions are very illuminating, and I enjoy them, as I enjoy the company; Sid's wife Traci is a beautiful lady, inside and out, and has done a spectacular job of raising their kids.

I hope you have your share of good times, great food and wonderful company.

Unw -

R

Report of 9 Aug '10

2010-08-09T11:58:00.000-07:00

Hello all -

This kind of stinks. I am sitting here nursing a sprained ankle. I so love the Boot Camp workout that when I twisted my ankle today, running in the dark, I was resentful. Chee chee chee. Anyway, I imagine it could be worse: the instructor told me that one of the participants, in the past, had clonged her head on the gym wall. I am glad that did not happen. It did mean I could not work out today, and I have been hobbling around the patients, trying to dexterously examine on one leg, overall looking ridiculous. The patients have been mighty understanding, though.

Work has been good. Cosmically aligning to finish out the course. This morning, as I swung in on crutches and finished up with the first patient, the second one wanted to leave. It was 8.50, his appt was at 8.30, and unfortunately he had been put in the room at 8.06. So 45 minutes later, the doctor was not in the room. I stand in the way of no one who wants to leave. I do feel bad, however, when I disappoint the patients, and abhor being late. But this patient wanted to see his regular provider, and that was fine with me, because I think those who cannot be fit in their regular provider's schedule must settle for 2nd best - i.e., me. :)

The patient who was refused Valium complained about me to my boss. All feedback is welcome and she really was spot on with her assessment that I appeared close-minded to the possibility of Valium; indeed, I was, and am. There are better meds, especially for an itchy rash. Other patients have come, and hugged, and chatted, and I especially like that. The young farmer with the frequent falls has some disc abnormalities on his MRI, and has been referred to a neurosurgeon. I hope for some relief for this patient, and will see him again in a couple of weeks.

Some fine times last week. My friend, Olivia, flew me out to Kansas, and her parents came in from western Kansas as well. It felt like I was with family and was great; we cooked Indian food together, and it helped immensely that our sous chef exemplaire, Olivia, had done the cutting ahead of time. Some delightful friends of Olivia's came for dinner and barely survived the heat of the food, but the intrepid Fondobles loved it. It was a fun evening, and I played dominoes for the first time. Olivia, her mother and I also saw "Charlie St. Cloud," getting a nice eyeful of Mr. Efron ("Zac Efron, really, Amma?" said my perplexed son) and caring a hoot for the story line. (Same way when we saw the dreadful "Catwoman" - "she (Halle Berry) doesn't have to act," said Scott.) It was a therapeutic weekend, and I returned rejuvenated. Olivia's gentle presence and powerful sense of humor will do that every time.

I spoke to all the men in my immediate life - my Dad and the 3 Weiss men. All are well, Naren reiterated that he'd be home the weekend I arrived, Navin said, "Really?!" when I said there were 4 weeks to go, Scott's messages continue to use complimentary adjectives, and my Dad said, "When are you here?" You can tell where the focus is. I have enjoyed my time here and appreciate all the folks who have made my summer oh-so wonderful.

Unw -

R

Report of 2 Aug '10

2010-08-02T11:15:00.000-07:00

Hello from Indiana -

Trust all are well. A new month is on us. And soon, a new year will be.

Several people asked very kindly why I got teary last week. Here's the story: I spend a fair amount of time explaining the ills of controlled substances to folks. If they persist in wanting them, it makes for a very frustrating encounter, with acrimony, which I detest. So, if I want to avoid this, I have to prostitute some of my beliefs which I do not do - and the impasse persists.

Busy schedules last week, but those are nice. I had a patient with a prominent lymph node in her armpit, and a family history of breast cancer. I sent her to a surgeon, and he removed the node and sent it for a biopsy (normal, thank goodness); follow-up with him was postponed as he had a death in the family. In the meantime, her armpit became swollen, and she could push it and squirt fluid out through a gap in the incision. She actually demonstrated this in the office. I was somewhat concerned about infection, or blockage of the lymphatic ducts, which drain fluid that collects the waste products from cells; I started an antibiotic and suggested she apply heat to the area. She returned this week, completely healed; there is a small lump at the incision, but she is otherwise free of the squirtings and swelling. At one time, general surgery was a consideration for my career choice - for joys such as this healing - but I headed elsewhere. This patient has also beaten a cocaine addiction and is back in school, and I commend her for both choices every time I see her. She is a lovely person, determined to succeed, and I wish her the best.

As I documented a physical exam last week, I noticed the left halves of the letters start to blur. I took off my glasses and shook my head, and the letters - on my note and on the posters on the wall - were still blurry. I checked to see if I'd just left a brightly-lit room for one less bright, and I hadn't; my left field of vision then looked like clear jello with multicolored wavy lines. This was a wee bit freaky - was I having a stroke? - and I asked my remarkable colleague, Nurse Practitioner Karen to examine me. Nurse Practitioner Beth would have done as stellar a job, but she had just left. Karen found nothing wrong in the neuro and eye exam, but thought the suddenness of the symptoms merited an ER evaluation. The ER doc was perfectly willing to see me, but he only had an ophthalmoscope to look in my eyes, which Karen had already done. So Karen sent me to the optometrist (I am really grateful to Karen for following through), who ably ran a battery of tests, and diagnosed me with ophthalmic migraine. Huh? The visuals were my aura - which indicate that a headache is about to hit - and then the headache hit. The optom and her husband suffer from the same condition (!) and she quickly produced a migraine pill and a Sprite to keep down the puke. I got home a tad exhausted, and paused to mull over the effects of aging, and illness, and illnesses that hit when one is not aged. The first thought through my head as I sat in the chair with the optom ruling out a retinal detachment - S.c.o.t.t. I didn't want to go through it alone, but all was okay.

Some fine times last week - I got together with Sid, his family, and 2 visiting lady missionaries to discuss Mormonism, faith and such. It was a nice discussion. I had not realised that was the purpose of the evening - thinking it was just a get-together to meet the missionaries, see Sid's family, eat some dessert - and so, got mildly disconcerted when the organised education started. It was actually great, though: I enjoy hearing about various faiths. I got to ask a lot of questions and we will meet again. One of my best colleagues from a previous job is Wiccan, and I have asked her a lot of questions also. I spent the weekend at the farm with some of my favorite people - Scott's mom, sister, aunt, uncle and nephew. We went out to eat, hung out, talked and laughed. My sister-in-law, Diane, and I visited her grandparents at the nursing home, and that was nice. I wish more people would visit their older relatives: it so recharges the latter.

Salsa continues well, with our instructor Dean's assistant, Audrey, having to lead like a male. She does very well, it can't be easy learning to lead. That class is fun, and I like it. Boot camp is fabulous and we do much running and twisting and crunching - it is a charge.

Inception, shminception. The best movie I've seen so far this year - "Winter's Bone." This year's "The Hurt Locker" for its realism. It was excellent, and the young woman who played the lead did magnificently. The supporting entourage also served to make the whole package fabulous, and I enjoyed the flick immensely.

I got to talk to my Dad, Scott and Navin, and that was nice. Naren has wanted to come home from the dorm for a couple of days when I return, and I was quite honored by that request.

Unw -

R

Report of 27 July 2010

2010-07-27T11:59:00.000-07:00

Hello from the world of Xanax and Hydrocodone -

As soon as patients say they *must* have these meds, it is a red flag to me. And then, as Scott's mother and aunt said to me, the ones who really need them won't get them.

There have been other patients who are much more reasonable. One of our rare younger patients, who is 20, came in after skateboarding and falling. He had an impressive bruise on his left hip and thigh, and could barely walk, so I sent him for an xray and there are no bones broken. The same patient had come in 2 years ago for a wrist sprain after skateboarding. As the nurse said, this young man apparently cannot see the connection; when I asked him about it, i.e., the plethora of falls and skateboarding, he said he did not mind, that he just loved the sport. To each his own, yes? I had another patient who had had a fall after "crowd-surfing" at a concert; he was 16, or so, and attractive, with long blond hair, and told me that he was crowd-surfing and "security was supposed to catch" him, but did not. This was hilarious; so security is not there to maintain law and order, they are supposed to catch those that are motivated to move along on the outstretched arms of fellow concert-goers?

One of the patients came to an appointment after shopping for groceries, pointed to the stash of groceries in her trunk (we were there to also get her bag of medicines), asked if I wanted anything; this was too sweet, and I accepted a banana. She pointed to some kind of German lunch meat, and said if she'd had bread, she'd have made me a sandwich. I was very moved by this, and as she was leaving, I gave her a hug, which I enjoyed. None of my patients here (and in India) is very wealthy, and all such gestures touch me enormously.

Some fine times last week. I got together with the doctors Diane and Patrick Healey, eminent geriatricians at St. V, for dinner. Their children and one child's friends were there as well, and the evening was full of peppy, intelligent conversation and simply scrumptuous food. We sat outside, which added to the lovely evening. My salsa class goes along fine: much depends on the person leading, and my instructor leads very well, so I found myself following the steps much to my surprise. I also enrolled in "Boot Camp," a fairly gruelling workout regimen, but very collegial and with others who will encourage the novices (I had to fall behind in a run with a body bar); it is bloody good fun. Zumba is fun, as always, and kick-boxing (or "Turbo Kick") with Stephanie rocks; she is an energetic and lively instructor, constantly moving around the room and working out near various students. I learnt about weights from a young man named Lloyd, and greatly appreciated the instruction; he and his wife are very fit, and I think I have learnt from a master.

Kris and Gabe graciously lent me the use of their home and I saw "Pulp Fiction" again, and laughed and laughed. I saw "Salt," which was the mindless, improbable fodder that summer movies are, and "The kids are all right," which was about a gay couple and their kids meeting the sperm donor; the acting there was quite first-rate.

I spoke to my Dad and there was too much static on the line for him to hear me; "shall we wind up, Renu, the vuvuzelas on the line are too much." :) The 3 Weiss men and I got to talk, also, and that was the merry fest it always is. Scott helped me through a tough day last week, simply listening as I whined and suddenly wept. Naren had been ill and that concerned me; he seems better now, and I was glad to talk to him. I told Navin that I liked Common of late (mildly replacing Russell Crowe), and he said he would download Common's music; I said, "Music? Who said anything about his music?" and Navin chuckled. It is nice to hear the men laugh on the phone, such a happy, contented sound.

Unw -

R

Report of 20 July 2010

2010-07-20T11:14:00.000-07:00

Hello from Indiana!

And the emails have begun - "Hi, beautiful," etc. Soon, all of us (the 3 Weiss men and I) will be emailing fondness to each other, and loving, and missing, and it will be time to go home.

But not yet, as he said in "Gladiator." Work has been just great, and I like sitting in on lectures and Grand Rounds. It is always, always nice to learn more. The patients have been mostly good, also. There was a patient who has emigrated here from overseas, and I saw him for back pain so severe that he is now falling. He's a young guy, and young patients are often a nice treat in our populace of older patients. "Back pain," however, is a red flag, as patients will ask for narcotic pain meds stating this reason. This patient, though, summarily dismissed all pain meds - "I am a farmer." And we laughed. I've asked for an MRI, and I want to see what's going on. What's cool for us is never cool for the patient, and I hope the patient regains good health.

I am now at the warm, loving home of Andy and Marybeth Simon, and their daughters, Miranda and Morgan. They are in Hawaii, and it is nice of them to trust me with their beautiful home.

Some fine times last week - I saw Spain, my preferred team, win the World Cup. Them vuvuzelas did sound like bees. I watched Isabella and Rosalia while the game was on, and plopped in a movie for them, though I would have liked to hang out and do girlie things. Sid shadowed us again last week, and my colleagues were nice to him (of course); it made for a fun day. I met my former colleague, Theresa Jefferson, for dinner at her house and it was just fabulous: Theresa is of the community that I admire greatly - Black women - and we had a blast. We talked of all things family and work, and Theresa mentioned her straightforward request to her grandson's mother to maintain the contact with him. I loved that; I see little purpose in vendettas where the child's parent prevents contact with various family members - it hurts the child the most, and deprives him/her of some solid, loving relationships which would complete the child quite nicely. I met Theresa's family as well, and enjoyed that. A bunch of female friends and I got together for a potluck dinner on Sunday - Colleen, Sonja, Boni, Lolly, Kris, Denise, Amy and Natalie outdid themselves in both food and conversation and I greatly enjoyed the evening, with all of us sitting around the dining table and revelling in each other.

13 July was my mother's b'day. I deliberately did not talk to my father that day. I called him the following day and we spoke at length of how difficult the day had been for him. 2 years ago, the 3 Weiss men and I wrote letters to my mother on her b'day; she so loved getting letters that she was delighted with this simple gesture and said she read and re-read the letters. She said that one of my sons was unintentionally very funny. My mother made our b'days memorable - presents as soon as we woke up, our favorite foods for a meal at home and then a restaurant meal at the end of the day. I wonder how her b'days had been. My father felt like chatting, and I appreciated that.

I am taking Jazz dance and salsa classes, and like them. I saw "Letters to Juliet," which was a bit dreadful, and "Inception," which was about 40 minutes too long. I also got to talk to all 3 Weiss men, and all were doing well - Naren taking part in inter-collegiate competitions (de rigeur for the average college student in India) and doing well, Navin performing well on school exams, and Scott holding up both home and work ably. There is no substitute for getting good news like this - it does make the day, and year.

Unw -

R

Report of 11 July 2010

2010-07-11T07:13:00.000-07:00

Hello from the warm and loving Rea-Soukup home -

The family is away at church. The girls, Isabella and Rosalia, are being "dedicated" today, and all were very well-dressed as they embarked on this momentous occasion. I managed to get a picture of this lovely family, and will preserve it.

Work has been fine, does not really seem like work. There have been the standard poison-ivy, blood pressure, diabetes patients. One of my patients, Ms. X, is a nurse married to an older man; they have adopted 2 children and live next door to an Indian family. The Indians do not celebrate Halloween (I suppose "observe Halloween" is a better phrase) or Christmas, and my patient said she asked their permission to celebrate these occasions with their son. I have no doubt this child appreciated it. My sons' favorite memories are of these 2 events. Free candy, who wouldn't like it. Ms. X epitomises to me all that is good and kind about the U.S. - welcome neighbors from another country, share all with them, treat the neighbor kid like their own, etc. Ms. X and I have had scintillating conversations, and isn't it true that motherhood has the same joys and challenges everywhere.

I had another patient come in requesting Valium for an "anxiety-driven" skin rash. "Requesting" is a polite term; "demanding" is likely more accurate. The dermatologist had agreed to the Valium but refused to prescribe it, the patient refused a referral to the psychiatrist, I too refused to prescribe the Valium, and the impasse has stayed. My father has often wondered why more providers don't work at such clinics in the U.S., as sometimes there is a premium in salary or loan forgiveness to work in such underserved areas. I pointed out this reason, that the demand for controlled substances supersedes all reason or rationality, and the visit deteriorates into an acrimonious encounter.

Some quiet times this week, and a chance to catch up on movies. I saw "The last Airbender" somewhat reluctantly, but quite enjoyed it. I talked to my Dad, and he's doing well; at the end of the call, I said, "Nice talking to you," and he appeared to really like that. I like communicating with my family; I am aware that there are families in which non-communication and vendettas are the norm, but I find these pointless. The 3 Weiss men are well. Naren is in the dorm and does not hate it as much as he had indicated; the young man had outgrown us - to kick a soccer ball around at 8 PM, or play his guitar, or take a walk at 10 PM with like-minded people, he needed to be in the dorm. We are happy he secured a spot. Navin is in the throes of studying - huge board exams loom in March, which will be here all too soon. Scott is holding the fort quite competently, and sends nice, detailed updates when we are not talking on the phone. The boys send messages, sharing much of their lives, and I feel very privileged; there are certainly secrets they don't share, which is appropriate, but they choose to tell me of other things, and that is very cool. One of the best things they have said before: "I wanted you to meet K/U/A; I knew you'd like him."

I attended a salsa (dance) workshop and enjoyed it. I also managed to chat a bit with Kris and Gabe, and enjoyed that, as always.

Unw -

R

Report of 6 July '10

2010-07-06T08:21:00.000-07:00

Hello from Indiana -

It was a weekend straight from Heaven. My kind hosts left me the house for the weekend and I watched movies until my eyes drooped, talked to the 3 Weiss men, watched Serena and our beloved Rafa win Wimbledon (I enjoyed both victories, and especially enjoyed the tremendous grace that the runners-up displayed in congratulating the winners, and the reciprocated class from the winners), and watched part of the World Cup. I also went to an Independence Day festival, and listened to live music outside, which was a joy.

Sid Norton, a friend interested in medicine, worked with us last week and that was great fun. Sid is a gentle presence, engaging and interested, and all enjoyed his visit. One of the patients (female and older) wanted to take him home. Sid and I had dinner later, and caught up on how his day had been, how health care providers' days are never boring, how much the profession challenges the intellect, etc. It was a nice day.

We had our standard patients last week, and Mr. X, the 600-lb patient, has fallen back into his ways of not following up regularly with the doctor. He is on a blood thinner for blood clots, and that needs to be monitored weekly, but he has not come in. We finally managed to get him in last week, and I saw that his gums were bleeding - too thin, that blood. So his medication was adjusted, and he was supposed to have returned today, but did not.

I spent Monday rounding with Dr. Love and that was great. He is a brilliant clinician, and I learn a lot from him, including from just hearing him talk to the patients. The peer relationship is nice, too, and Dr. Love's sense of humor keeps the day going by very easily. He is very kind to let me follow him thus.

The gym goes well - odd place, if you truly notice. There are all manner of individuals working out there, and not just for the purpose of improving their health, either. But it remains a fine place to exercise, and I enjoy going there. I also take a Jazz Dance class with older adults, and I am impressed at the flexibility and grace that they exhibit; I used to think that Indians had a fine sense of rhythm, but abundance of grace there ain't.

Unw -

R

Report of 27 June 2010

2010-06-27T10:43:00.000-07:00

Hello from the Carmel library -

From the New England Journal of Medicine, 10 June 2010: "Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. ... moreover, using a hands-free device does not make talking on the phone any safer. .... driving while distracted is roughly equivalent to driving drunk ..."

Driving and talking on the cell phone is illegal in India; first offence causes a fine, I think, and second offence causes a permanent loss of the driver's licence.

Trust all are well. I am fine and just finished my first full-time week of work. It was nice; any day that one can work is a good day, and I look forward to working until I am 90. If that is my life span. We had a male patient come in with nipple pain, and I have sent him for a mammogram; breast cancer in women is slower to spread due to the abundance of fat in the breast that the cancer cells must traverse before they hit the chest wall, and in men, the cancer cells hit the chest wall directly and spread rapidly. Thus, breast cancer in men is much more aggressive. I also had a patient come in with shoulder pain; as I entered the exam room, there was a veritable entourage in there - a total of 3 women, and the room reeked of cigarette smoke. The patient told me her regular doctor had done nothing for her, a train of thought I did not encourage. She told me of her shoulder pain, and I examined her and have sent her for an xray. She also told me of "nerves," which I am ill-equipped to handle, and so I suggested that she see a psychiatrist, which she was willing to do. I told her of the part she must play in healing, which is to stop smoking. Her mother and grandmother were in the room, the mother mentioned a history of osteoporosis in herself, and I suggested she stop smoking also. She seemed flabbergasted to hear that smoking and osteoporosis are connected; indeed, they are.

If the patient is young, I don't enjoy umpteen related people in the exam room, unless absolutely necessary. As evidenced above, these visitors end up talking about their own health issues, or irrelevant matters, or bicker, and the visit ends up taking off elsewhere. My older patients are very welcome to bring relatives, as I consider dissemination of information to the family paramount in such folks' care, and sometimes I have to rely on relatives for an update on the patient (a "history").

Some fine times this week: former colleagues from Medical Education at St. V, Ruth Ranalletta, Tami Horkay and Boni Hypes, and I got together for dinner at Ruth's home. She grilled burgers and portobello mushrooms, and all of us talked, ate, laughed. I had 1/3 of a margarita, plenty of food and great conversation, and the evening was pleasant and comfortable. I don't recall when all of us stopped talking and laughing, but we did have to leave as we had to work the next day; I left rejuvenated in body and spirit, and grateful for the presence of these folks in my life. Kris and Gabe, my current hosts, had some time to chat this week and that was wonderful; their perspective on life, work, family and much else is pretty fascinating and we talked and laughed also. They have finished a busy 2 weeks very successfully, and I was very happy for this lovely couple.

I spoke to my Dad today, and he had been to Bangalore for a talk, plus had visited a widower friend. Both men lost their wives on 21 Feb 2010 and 22 Feb 2010 (my mother), and had much to talk about. My father considers himself blessed that all of us check in on him, and expressed that thought clearly; it was nice. I also talked to the 3 Weiss men and that was hilarious; Scott had had to referee the umpteenth fight, and was worn out, then the boys came on the phone and professed complete consideration of their father. I laughed and laughed. I imagine other mothers of teenage sons who live to irritate their fathers can relate.

Movie-watching goes on and I saw "Knight and Day" yesterday. It was okay; the luminous Paul Dano only had a bit part, but the movie was quite entertaining.

Unw -

R

Report of 20 June 2010

2010-06-20T11:05:00.001-07:00

Hello from the Carmel library -

Books, books, books - free. Such therapy.

Happy Father's Day to all! This year, more than ever, I am aware of the contributions a father makes, and I hope all the phenomenal fathers on this reading list have a great day. I talked to the 2 fathers in my life - Scott and my father - and wished them. FD is not celebrated in India, and my father thanked me for the wishes. Naren and Navin had made Scott breakfast, his present having to be left behind here ("My presents are here in Chennai," said Scott), and Scott said he had enjoyed the day, which I was happy about. Naren reached home safely, sans "Random Security Checks," and I am relieved. There was a time when air travel was not the worrisome mess it is now.

Naren got safely off the ground at O'Hare - several pounds lighter as his baggage was overweight with candy and deos and junk that all of us had bought. So things had to be unloaded into the trash bags that I had taken along, and I brought them back with me. As I waited for Naren's flight to take off, I told a young lady that I had sat next to that I was not normally embarrassed by much, but having to wheel a cart around with 2 trash bags on it was truly a new, somewhat awkward experience.

I am now at the warm and loving home of Kris Rea and Gabe Soukup, and their daughters Isabella and Rosalia. My father was a bit concerned at the new location, asking if this was by choice or whether I'd been deported by the Tabers. :). It is by choice, wanting to spread out the pain of being a houseguest over several households. Naren and I had stopped by this house on Tuesday, to drop off some of my things, and Naren enjoyed the time he spent with the little girls. He talked of little else on the ride back. The home and people are truly lovely. There are more trees in the Rea-Soukup backyard than our entire Chennai street, and I have spent every evening sitting out, reading. It is beautiful, and relaxing.

The practice got busier, to my delight. It is nice to be busy, the day flies by, and we have taken care of many. The support staff at the clinic vary their pace of work accordingly and are customarily efficient, which is wonderful, and I appreciated "being run" by someone who put the patients in quickly, so that I could then do my job. One of our colleagues has been away in China to adopt a baby girl, and we have seen his patients, which has added to the nice busy-ness. One of the patients had called in saying her blood sugar was 47, she had been nauseated and unable to eat anything to get her sugar up; I did not want to field this issue by phone and asked that the lady be brought in for an appointment. I saw her on Friday: she was pale and pukey. I went through a very detailed history, saw that she'd had prior stomach surgeries, and asked for a cat scan (CT). It showed that she might have a partial bowel obstruction, and I have referred her to a surgeon. I phoned her soon after the CT results came, shared them, and asked how she was: she had been following my suggestion of small,bland meals, and the crackers and Sprite were staying down for the time being. I was pleased. The appointment with the surgeon is for tomorrow, and I hope the lady does well.

It is nice to work in a country where I can order a CT scan without worrying about its effect on wallets.

Naren and I finished some last-minute shopping before he left, and ate some junk food. We talked for a while over the meal. The boys are very opinionated (where do they get that?!), and I enjoy their opinions immensely. At one time, when we had to discipline one of them in India, he said, "I understand why you have to do this, but I don't like it." Naren and I saw "Harry Brown," the story of a vigilante, and I found it well-acted but unrealistic; Naren then mentioned a similar movie in Hindi, "A Wednesday," which was very slickly done and was completely believable. So we discussed that, and other things, and then it was time to return to the friendly Taber home (where we were until Naren returned to India), and watch the basketball game. The rats Celtics lost to the Lakers, and I was disappointed with that outcome.

My sister, Anu, was in the U.S. last week for some important meetings. She is a researcher of considerable caliber, and is in trials with Johns Hopkins, and researchers in the U.K. and other countries. We did not manage to meet, or speak on the phone, but caught up over email. She hoped that I did not miss my family too much. There was a very needy email from Chennai right around the time Naren left: it was something that could have been handled easily right in Chennai, but for some reason, I was roped in. Tell the wife and mother, she'll handle it. Que? Enna? Quoi? Entha? No, no, no - wife and mother is elsewhere, taking care of her own affairs and patients, and other capable individuals can handle the Chennai issue. As always, the cosmos righted itself, and I was soothed that I had really no occasion to miss the family too much. Let the workouts begin, let the movie-watching and eating vats of fruit continue, let the business of catching up with U.S. friends start. In a couple of months, all of us (Weisses) will feel the need for each other and then mindsets will change.

Unw -

R

Report of 13 June 2010

2010-06-13T12:49:00.000-07:00

Hello from the Tabers' warm, friendly home -

It is nice to sit down, isn't it, and not drive around madly. We've had to catch up on movies and shopping and farewells, and I am happy to have a Sunday at home. The room I have here is wonderfully comfortable, and a perfect sleeping environment. The Tabers' uncomplicated, genuine hospitality is always a treat.

Work has been good, and St. V has been kind about letting me work part-time while the family is here. The patients are nice, and chatty, and not venomous. There is a young man who has been evaluated for bariatric (weight loss) surgery, and is sincere about losing weight. He exercises more now, and I am grateful for having attended the conference in Toronto that told us three 10-minute sessions of exercise do equal one 30-minute session. The thinking previously was always 30 minutes of continuous exercise 5 days a week. As I commended this young man for his choices, including a salad daily, I paused to consider his influences: he weighs 600 lbs, and had to drop out of school to care for his father, his mother having left when he was very small. His 16 yo sister lives with a 50 yo boyfriend, and I felt sorry for the young people, that they had nobody to teach them right or wrong, whether in diet or in life choices. The young man comes to the doctor regularly now, and I am very pleased; we will get him healthy yet.

My mother seems more and more wonderful daily.

Scott and Navin reached home safely: a great relief in today's air travel world. Naren and I spent a therapeutic week alone here; the Tabers were away on vacation and it was nice to have a whole house to ourselves. We watched the NBA playoffs, unfortunately having to forego an early morning workout the next day. We watched a lot of movies at home, including one that Naren recommended: "City of God." One day, we made brownies and Naren licked the pan afterwards; whether 9 or 19, that pan holds a certain allure, does it not. We also saw "Get him to the Greek," "The Karate Kid" and "The A-Team." TKK was very good, with outstanding performances by Jaden Smith and Jackie Chan, and a very respectful depiction of another culture.

We were at St. V's residency graduation on Friday, and I enjoyed the meaningful speech that the keynote speaker, Dr. Pat Healey, gave. I like this event a lot, because senior physicians often talk about the meaning of medicine as it applies to them, which I enjoy immensely. Naren was bored witless with all the socialising, and Dr. Robert Love was kind enough to sit near us to engage him in meaningful conversation; I appreciated this greatly.

I had to go to the dentist with an emergency, and my nice colleague Beth's husband, Dr. Scott Prusinski, treated me for free. Over all my protestations. His extremely professional and competent manner, and his sense of humor, made the visit very satisfying, and I consider myself very privileged to have such kindnesses come my way.

We took Menfil, the resident visiting from Guatemala, with us yesterday to the farm, and all had a nice time. Scott's cousin Deb was down with her sons, and that was good fun. A most rejuvenating day was spent gabbing and eating and laughing with some great folks. Menfil's English is good enough to sustain many a conversation, our Spanish regretfully isn't. On our way back, we got caught in a severe rainstorm, and lightning hit a post about 15 feet away from us; there was a blinding flash which lasted several seconds, sort of like a fluorescent light being turned on, and it was very cool. Only later did I realise that we were lucky to escape harm. It is amazing how God protects us in all kinds of situations.

I spoke to my Dad, and he mentioned having talked at length to Scott. "He talks sense, Renu," he said, and I started laughing. As he wondered why, I said that Scott was a sensible and pragmatic and affectionate sort; when my father had mentioned being lonely, Scott had invited him again to come and live with us. My father has declined again, but he knows the welcome is there, and that counts for something. I hope Scott's and my epitaphs read "Got along with the in-laws;" that is a great gift for me.

Unw -

R

Report of 7 June '10

2010-06-07T11:43:00.000-07:00

Hello from Indiana -

Before I forget, our single friend, Craig, wanted me to tell everyone that he was single, dashing, well-dressed and liked long walks on the beach and short flings.

The week has been okay. It has been nice to have my family here with me. Scott and Navin reached Chennai safely, minus "random security checks," as Scott put it. They were in the land of high heat, and having to take multiple showers. Navin is combating jet lag with a vengeance, and has been asleep early many times that I've called. Resuming school and work routines has happened, as has doling out the American goodies bought for others, which many folks look forward to.

Naren spent the rest of last week with his grandmother, grand-aunt and -uncle, and I got him yesterday. Spending a night and morning with the in-laws was fun, and we talked a ton, which is always very therapeutic. Naren has some shopping to do yet, and visiting up here. We took Menfil, a resident visiting from Guatemala, out to shop and dinner yesterday, and that was great fun; Menfil is 27, more my kids' age than mine (as much as I think the residents and med students are getting younger every year, there is also the realisation that I am getting older), with a very good sense of humor, and much laughter ensued in the course of the evening. It is always, always good to laugh.

The patients have been wonderful. One of the ladies this morning, an 84 year old with foot pain, flashed me a very "Mom" look as I poked at the exact source of the pain; it was so filled with annoyance, due to the elicited pain and perhaps due to me as well, that I burst out laughing. Her daughter and she joined in, and I mentioned that all us Moms must perfect that look. I have sent her for an xray, and am hopeful that Home Health can look in on her. Another patient with an umbilical hernia came today complaining of pain, and we talked a bit; he is not very old, but has a son married to a woman in Japan, living there and not quite likely to move back. That reminded me a great deal of Scott, and we talked for a bit. It was nice to chat. The patient's abdominal cat scan (CT) came back showing an inflamed hernia, and I have referred the patient to General Surgery.

I saw "Sex and the City part 2." Even bawdy humor can be funny, and I was prepared to accept this movie with its unique cultural slant; however, it tried to mix too many things up - marriage, single life, complexities of relationships and then threw in 4 "trampy" women visiting the Middle East for good measure. It was not enjoyable, with extremely shoddy acting, and I nearly asked for my money back. Naren and I saw "The Ghost Writer" at the $1 cinema, and I contrasted Kim Cattrall's fine performance there with her suboptimal turn in "SATC."

We were delighted that the Celtics won. Great game, including Ray Allen's record of 8 3-pointers. I did not see the French Open, but am happy Rafa won.

Olivia gave me quite a few clothes from her closet, and I have worn the clothes, and felt singularly well-dressed - completely outfitted in "Olivia Fondoble," as I always say. It is lovely to get a nice, new wardrobe annually, without having to go through onerous shopping.

My gentle husband talked to my Dad and said he was feeling chatty. It is nice to get along with one's in-laws, and extremely nice to have one's spouse get along with one's family. Naren has mentioned that I seem to say many things my mother used to, and refer to her a lot, and I imagine that will continue for a while.

Unw -

R

Report of 2 June 2010

2010-06-02T07:16:00.000-07:00

Hello from Indiana -

It has been a frenetic, but fun, few days. Normal routine went for a toss, as we visited relatives and friends, ate, ate, ate and accommodated the men's shopping.

Maryam Massoumi, her husband Ali, and kids Rustom and Golbarg had some other friends and us over for wonderful Irani food. It was a great evening, with Maryam and Ali's all-encompassing hospitality, good food and lovely company, and a memorable time was had. The kids totally enjoyed romping with Rustom and Golbarg. We stopped by the Simons' for a second dessert, and the boys caught up with childhood friends, Miranda and Morgan, which everyone appears to have enjoyed. It is always a treat to see all of them, and the sweet, generous Marybeth Simon even sent dessert home with us.

We spent Friday hanging out, eating b'fast at a nice restaurant where the all-you-can-eat pancakes were huge and Navin had *one*; Scott said the next time, Navin could order the "All you can eat pancake." We saw "Prince of Persia" and "Shrek," enjoyable for the men's company. There was little casting accuracy in PoP; surely there are actors of Middle Eastern descent who can play the roles? And when did tank tops make their way into battle? Mr. Gyllenhaal's mighty muscles had to be accommodated, I guess.

We spent a day down at the in-laws' farm, helping the vet with cow and calf maintenance: shots, ear tags and castration. It was expected to last 2 hours, given vagaries of cow and calf moods, but finished in a little over 1 hour. The vet was appreciative of all the assistance: there were about 10 helping (some in closer roles than others). After that, my mother-in-law provided an ice cream cake for Navin to cut, and I can think of nothing better than to spend a b'day with relatives and eat ice cream cake for b'fast. We stopped by Scott's grandparents' nursing home to say a quick bye, and the folks were so happy to see us that we extended the visit by a lot longer and stayed for lunch. Scott's grandfather's snide observations had the boys laughing non-stop. We got back to Indy, saw "How to train your dragon" by Navin's request (it was very good) and then caught up with Shilpa, Ravi, Keerthi and Surya Mallur, which was very nice, in their lovely new house.

On Sunday, John Sparzo took our sons to the Indy 500 and Glenn Fondoble, my friend Olivia's Dad, took Olivia, Scott and me. This was the first race for the Weisses, and the spectacle was impressive: the speeds, strategies, female drivers, unpredictability, all of it. Olivia and Glenn are pros, and we benefited enormously from their expertise, and thoroughly enjoyed their company, too. Not much conversation went on, of course, due to the ambient din and need for earplugs. Glenn was smart enough to choose the family section in the infield, which had trees, and I spent a grand afternoon in shade, watching magnificent machines and expert drivers handle them. A fight broke out among fans on the road in front of us, with punches being thrown and blood being drawn, reinforcing my conclusion that excessive alcohol use certainly hampers one's judgement in more than 1 way. This did not take away from the event, or from getting together with the Fondobles.

We got together with the Sparzos, Carolyn and other friends for dinner after the race and it was great. So much conversation flowing, laughter, great humor, and a welcome to all. Mandy Sparzo made the food and it was delicious. All of us had a fun time. We spent Monday with the Tabers, packing, and Melinda Taber came down from Ball State to visit, which was lovely. Mark Taber made a spectacular Memorial Day meal, and all of us ate to bursting, and had a scintillating conversation around the dinner table, full of opinions and news and chitchat.

Naren and I dropped Scott and Navin in O'Hare yesterday, and drove back, singing along with the classic rock stations. If 1 June has rolled around, 1 Sept cannot be far away.

The patients have been fabulous, too. One of them is an 89 yo, delightful lady, who'd inadvertently fallen asleep with a pot of beans on the stove, and awakened to find them burning. I had asked for home health help for her, and the good folks had helped Ms. X with her bath and exercises. During the visit in our clinic, Ms. X's daughters looked at me as though I'd worked a miracle; I had not, I had merely used the resources so wonderfully available here, located by our efficient and fine front office staff. It is nice to link people and help so easily. The older patient populace is a treat, with their life experiences, classic humor and gentle acceptance of all that life dishes out.

I talked to my Dad today, and he was extremely loquacious. Our cook - shunned, maligned and abused by her parents - got married today with the assistance of a bunch of people. She is a sweet young lady, and I wish her well; my Dad signed as her guardian. It was nice to talk to him.

Unw -

R

Report of 24 May 2010

2010-05-24T13:12:00.000-07:00

Hello from Carmel public library -

Such a great place. Books, books, books, the Internet. I am hungry today as I type this, so cannot fully appreciate this place as my stomach is growling.

We are well, and back in town after some travels. Before we left, we had the pleasure of having lunch with Brenda and Jim Hillman. Jim was the manager of Medical Education at St. Vincent, and we have kept in touch since both of us went different ways. We try to see the Hillmans every time we are in town, as they are lovely people, and Brenda outdoes herself with the meal every time we meet. No different this time: after we had looked around their lovely garden (they are Master Gardeners), we ate. And ate and ate. We talked about all topics possible, the kids played with the dogs, and it was a memorable time.

We left town on Friday the 21st, and stopped by my Temple friend Angelique's place in Bernville, Pa. It has been over 20 years since I've seen the gracious and beautiful Ang, and what was to be a 30-minute visit ended up being 3 times that, involving the Weiss men easily in Angelique's inclusive conversation, and lots of catching up, which was lovely. We headed onto Scott's cousins' place - Jeff and Anne are warm, funny people and have 2 daughters, Claire and Helena. I usually live vicariously through Anne as I have no daughters. This stop was very therapeutic and laughter-filled, for all. We then saw Ann and Phil Bagley, parents of my friend Doug, but now friends of mine as well. They epitomise class and grace to me, and we had a nice time gabbing away. We saw Glenn Gross, my Temple friend, who has beaten cerebral palsy enough to get a Ph.D., and now works for HUD; we had pizza and some sinful pastries and could not stop talking or laughing. Glenn's sense of humor is legendary, and the boys could not help but laugh at some of the things he said. We missed Beth Gross, who had another family commitment; I have met Beth, and can attest to her goodness. We then went onto NJ, where a friend had organised a fundraiser for the Banyan; it was a family endeavor with her husband, her Mom, and her kids pitching in. It was a very nice evening, with a lot of her friends easily sharing their goodness with us. She is a beautiful (inside and out) young woman with very expressive eyes, I have only known her for about 2 years and yet we carry on as though we met 30 years ago - such is her heart. Which has, for long, wanted to give back, and so, she has chosen to give back to the Banyan. Lucky us. We were happy that Scott's friend, Craig, drove down from Baltimore to see us at this event; Craig is a dear sort, avowedly single ("I need to take your sons to Hooters" "No, you don't"), and we always have plenty to talk about, since his irreverence is a treat to be around. We spent the night at a friend's place, and I loved being around her dear mother, who fed us non-stop, packed some food for us (including some sumptious walnut halwa), and talked away about all things Indian and not. I am a big fan of parents of friends. We then got together with childhood friend Farshid, his wife Savita and kids Sasha and Keya. My parents have known Farshid since he was born, his parents have known me since I was about 4 or so, I call his father "Sasuro" (father-in-law), and there is a giant kinship with Farsh which the years or circumstances have not diminished (I am fortunate). Savita is a lovely addition to this family, and we have appreciated seeing them whenever circumstances allow. This stop, also, ended up being much longer than planned due to the unending chatter and laughter.

Work has been good, and the patients are trying to do as they are told. I walked into the exam room of a 17 year old patient the other day, and his mother and a baby in an infant seat were also present; the 17 yo very quickly told me, "He's not mine." I am happy the young man still remembers lessons from last year: Abstain, but if you must experience intimacy, use protection. His initial reaction to my entry, quickly disavowing parenthood, was extremely funny, and I laughed out loud.

Naren and Navin joined me in speaking at the fundraiser. They said poignant things about what they had seen at the Banyan, including the wide smiles on patients' faces. Unknown to me, Naren had promised Navin $10 if he could use the word "Woof" 10 times in the speech. So Navin said things like: "I am grateful to Vandana and Vaishnavi, woof ounded the Banyan, to my mother woof orced me to speak tonight," and so on. Naren started laughing in the middle of it, and leaned over to say something to Navin, which I found out later was "You are at 8 so far." Navin got all 10, got the $10, and the boys shared a camaraderie, which I found quite cute. The trip was by car and a friend asked if the boys don iPods as soon as we head out; I said No, they are forced to converse with us, or all vote on a radio station, etc. It was a nice trip, though cramped (even for my short legs), and I am glad all of us got to go. The bond with the 3 Weiss men is something I always feel blessed for, and the men know that they are the most important people in my world, and that I am okay with the fact that, currently, I may not be among the most important people in theirs.

My father is well, I spoke to him last week and the call was short as he had visitors in town for the 10th anniversary of the Smile Train. He stays active, which I am happy about.

Unw -

R

Report of 18 May 2010

2010-05-18T11:20:00.000-07:00

Hello from Indiana -

A great many things got accomplished last week, including seeing an icon: the Dalai Lama was in Indianapolis at a paid event, and we went. I have long admired the man, and consider many of his qualities emulatable, if that's a word. Had we sat close enough (where the "Supporters and Friends" were), we might have understood more, especially as we are very comfortable with the accent from the Indian subcontinent. We were a bit far away, had to crane to hear, the sound system was not very good, and we got bits and pieces. Naren understood the most of all, but all still felt humbled to be in his presence. For a leader to be bundled out of his homeland by another country (what on earth does the other country want, other than contiguity - there is no oil, no gold, no nada in Tibet), and to not harbor any rancor or malice, to epitomise all that is peaceful and good - ahhh, what a difference, what an example.

There are certainly egos to be satisfied, and political accommodations to be made which I will not understand easily - many which prevent condemnation and a "Go back to your own seat" advice. It remains, however, my dream that Tibet will one day be Tibet, an independent nation and not a province of China. We had Tibetan refugees in Madurai, all very good-looking and selling woollens, and as schoolgirls, more than one or two of us strolled by their vending area - and that was not to buy woollens.

Work has also been great. I had an older patient with an exacerbation of his Chronic Obstructive Pulmonary Disease (COPD), and had given him some steroids for it. He returned feeling much better, and in the course of the visit, turned and muttered something to his younger wife (this couple generates some attention because he is older and she is a bit younger). She said to me, "He said that pill, the prednisone, made him feel better, and wants more." The patient had eaten well, was breathing better, had managed to plant 14 tomato plants and was in a good mood. In the course of the examination, I looked at the tattoos on his forearms, shared details of Scott's grandfather's tattoo, and we laughed. It was a fun time, and it was nice to see a previously very unhealthy-appearing man laugh.

We saw "Brooklyn's Finest," "Furry Vengeance" (the kids' choice) and "Robin Hood" (clearly my choice). I enjoyed Robin Hood, being a big Russell Crowe fan, and consider his pairing with Ridley Scott to be *quite* worthwhile. We got together with several friends to eat Indian food at my friend Carolyn's house, and that was nice of her to lend her place - and her parents, who came down just for the occasion (along with a vat of cookies, almost instantly devoured). Sid was sous-chef, Sonia brought bread, Carolyn made a salad, Maryam made Irani dip, Natalie brought cookies, my sister-in-law, Diane, brought brownies, Jacque and Cindy B brought flowers, Mary and Cindy S brought chocolate, plenty of folks brought their geniality and affection, and it was all good, filled with bonhomie and warmth - quite what my mother, in whose honor the meal was, would have loved.

The more I see my patients, the more I am grateful for my parents' upbringing - through all my umpteen mistakes (none of which they have revealed to the boys), they stayed supportive. I spoke to my Dad last week and he must have been feeling chatty, because he talked for a long time, and that was lovely. He terminated the call when it was time to take his walk, and I am happy that he is exercising.

Unw -

R

Report of 10 May 2010

2010-05-10T10:13:00.000-07:00

Hello from Indianapolis:

It is 10 May 2010 and the heat is on inside the building. It is cold outside, and so, the heat has been turned on inside. We left 104 degree weather in Chennai.

A very beautiful sight emerged at O'Hare last Tuesday. Our older son, Naren, walked through the doors - quel relief. I had asked that he cut his hair and shave prior to travel, and neither had happened. He got pulled aside for, as he put it, a "random" security check in Frankfurt. He emerged unscathed, from that and from Immigration in Chicago, to our great relief. Naren said everything was so easy, he walked out expecting to be stopped by *someone.*

A belated Happy Mother's Day to all the moms! Trust all had a good day. As Mother's Day is not an Indian celebration, I did not dwell too much on my mother, except for missing her. My friend Sid sent me a nice note, hoping I was doing ok on Mother's Day. The 3 Weiss men gave me a pretty candle, a nice hand-made card and a spectacular poster made by them; it was a collage with words (many complimentary) cut out from media, describing me, and was absolutely wonderful. (I have outgrown candles, which none of the men has noticed :), but no matter because this poster more than made up for that.) Part of the phrases: "Values us" (I am glad they know this) and my favorite, "Her height rules." The best part of Mother's Day weekend, however, was the boys' response to a narrative by Scott's aunt detailing how she and her husband had been to a restaurant, had to wait, and none of the young people in the waiting area offered them seats; the boys looked at each other, and said, "If my mother had been there, heck, regardless of which continent she was on, she'd have come over to us, smacked us and made us get up." That was beautiful. I am happy they know my course of action.

Work has been good. I had a patient come in for a physical exam, and in the course of our conversation, I found out that she had gone back to school and had kicked a cocaine habit. I was extremely impressed with both achievements and said so; I like it when folks haul themselves out of poverty by educating themselves. And, I am unfailingly impressed when people manage to overcome an addiction. I gushed as much to the young lady, and we talked for a while. I had another patient who came in with a belly ache, and as I was sorting through my questioning to find out the cause of the ache, the patient said, "And I drink too much." Osler said it - "Listen to the patient. He will give you the diagnosis." The man went on to say he was on his second marriage, and that he had got divorced because, among other things, his then-wife had become too fat. Deep breath, Dr. Weiss. Count to 10, *count* - 1, 2, 3, 4 - "Well, Sir, don't you think your alcohol consumption might have played a part, too?" (The annual goal to keep the mouth shut fails regularly.) The man said it was a part, but that his romantic notions towards his wife had decreased. Hmmm. At my heaviest, I weighed 178 lbs when Naren was born, more than Scott, and I am a foot shorter than him. If my adoring husband had left me then, I think my life would have been pretty rocked.

Some fine interactions last week: Scott's cousin Debbie met us in Chicago and went with us to get Naren. It was good to see her. We spent 1 night with my sister-in-law, Diane, and her family, and then met the rest of the in-laws the following day for a huge family gathering and Game Day. The in-laws are rowdy people and unfailing good fun, so it made for a memorable day. My sister-in-law, Marybeth (Scott's brother Mark's wife), gave me a nice, extra warm hug as she has lost her mother, too, and we now have this common bond. We visited Scott's grandparents in their nursing home and Scott's grandfather kept everyone laughing with his tales of playing the horses on his last b'day and hating life at the nursing home. We spent the night with Scott's aunt and uncle at their farm, and cooked Mother's Day lunch for all the moms. Naren, Navin and their cousin, Oliver, helped with farm chores ad infinitum on Mother's Day and doing for someone else helped ease my sense of mild emptiness. We saw "Iron Man 2," which was very enjoyable; I was very tired during the flick and kept sighing heavily, prompting the son sitting next to me to announce later, "Ok, someone else sits next to Amma at the next movie." As we ate at a favorite restaurant after the movie (one of the boys' favorite sequences - watch a movie, go out to eat), I looked at the 3 Weiss men, talking, laughing and eating, and I agreed with Perseus in "Clash of the Titans" - "I have all I need, right here."

My Dad got through his cataract surgery well, I talked to him and to my sister-in-law, and all of us had lots of laughs. That was nice.

Have a good week.

Unw -

R

Report of 2 May '10

2010-05-02T12:21:00.000-07:00

Hello from el Carmelo public librario -

What a place - books, computers, magazines, newspapers - all free.

The week was very long. I saw a good number of patients, and one day was so busy it ended before I knew it. I serve a fairly poor, underserved populace and love it. A memorable patient was the 15 year old boy with back pain: he'd swung a baseball bat in gym class and "something ripped." It was not a big effort to fit him into the schedule as I was not busy that day, and the mother was profusely grateful. Amazing how little things can make people happy, things we would just do in the course of a work day. After treating the boy's back pain with anti-inflammatories and prescribing some rest, I addressed his obesity: he was 5'8" and 250 lbs. We heard at the conference last week that about 70% of U.S. adults are overweight and a full 1/3 are obese; I do not know the statistics for children. We were also told the next generation's life span would be shorter than ours. Eeek. All due to overeating. There was also the theory that obesity might be due to a virus, and I found that extra arrogant. Unhealthy foods are inexpensive, and if one has grown up eating junk, one is inclined to think that's a normal diet, and propagate the cycle with one's own family. Scott still eats massive amounts of candy when he gets to the U.S. I think if the average patient were educated about eating, we might have some informed patients. Self-esteem is so based on appearance here that that might lead to some good choices.

I had a really enlightening experience at the gym the other day. I inadvertently sat on someone else's bike in spinning class, and the lady said loudly to her friends that I had taken her bike. It would have been equally effective to come over and tell me the error, but the public option was taken. As it turned out, the lady (very attractive and fit) and I had the same brand of water bottle, and I had placed mine on the bike next to hers and walked away to return later and climb on a bike that I thought had my water bottle on it, so this was a very surreal experience for me. It didn't matter a ton, since I have been to spinning class for 2 years, and I apologised and got down, then moving very far away from her, but the public announcement continued briefly. It struck me then that this must be what teenagers go through in most gym classes in intermediate and high school, that there is apparently (according to my spinning instructor) a certain persona who'd dominate the session and try to make someone else feel awkward. It helped considerably that I am 46, and could choose to move away; I am now exquisitely aware of what younger women go through. And understand what Scott and several American friends mean when they say they hated high school. This kind of stuff sure is new to me. Parents tell me there is a new trend to bullying in schools here, and I hope for the kids' sake that it peters out.

Scott is eternally grateful that the kids have gone through high school in India, with small classes, little bullying, a chance to celebrate differences rather than critique them, a grand appreciation of all. I, too, have paused to notice how Naren and Navin go out of the way to include kids who are shy, or chubby, or stutter, or otherwise don't fit in. One of my favorite memories is of our teenage Brazilian neighbors, Pedro and Felipe, being at a party at our house with a bunch of the boys' friends, and at least 1 son hanging with them the whole time. Pedro and Felipe spoke some English then, my sons spoke no Portugese, but a common ground was found with little effort. And all of us grew to love Pedro and Felipe dearly - piercings, tattoos and all.

I spoke to my father last week, and he was *delighted* to get my call. That was nice. We gabbed for a while about all matters, and he stated that my sister-in-law, Susan, and niece Sanjana would be in Madurai next week to help out while he had his cataract operation ("Susan rises to the occasion again," he said). I am struck by how fortunate I am in my in-laws. My Dad and I chuckled about other things, and finished the call in good moods on both sides of the planet. Scott, Navin and I spent part of the weekend with my in-laws here and that was the merry fest it always is; Scott is spending a couple of days there to bond, we always follow one of my bosses' suggestions that adult children must spend time periodically with their parents without spouse or kids in tow. We reached around lunch time, and promptly ate. And ate, and ate. We also talked and laughed, and enjoyed each other's viewpoints. These are folks with abundant senses of humor, always, always, making for a good time there, and I returned rejuvenated.

We also tried to see the 3-D "Clash of the Titans," but there was a power outage and the theater gave us some passes to compensate. Navin counted 13 people in the theater, unheard of in India, where movies are almost always house-full (sold out). I have talked every day to Naren, and my heart will continue to be in my mouth until that kid walks through the doors in Chicago.

Unw -

R

Report of 26 April 2010

2010-04-26T11:32:00.000-07:00

Hello from the affluent United States -

I am sitting in climate-controlled surroundings, I drove my car on good roads this morning, I worked out at the very nice Fishers YMCA at a spinning class taught by my good friend Sid and saw fun friends Natalie, Chris, Mark and Lisa (it was great to start the day with such a workout), and got gas pumped for me by a handsome and very polite young man - nice to live in wealth.

Last week was spent at the most therapeutic home of school friend, Derrick Poppen. We were classmates when we were 10 years old, and parted ways about 5 years later. Derrick lives in Toronto with his wife, Jacquline, and children Aaron and Alisha. We stayed with them, along with one of Derrick's college friends, while I attended the conference of the American College of Physicians, and that was lovely - like staying with family. When one's male friend invites you to stay, you always want to be certain it's okay with the spouse, and Jacquline was hospitality incarnate, with delicious meals daily, and a warm, loving persona. The kids were, in particular, delightful, and were mature and gracious beyond their ages, even corraling their Rottweiler, Robin, while all of us were in the house. Jacquline and Derrick invited another school friend, Sam, and his family for dinner on our last day there, which was very kind; it's been about 20 years since I've seen Sam, and all of us caught up (sometimes in Tamil) with nice reminiscences, and memories of a time when all of us were in school, innocent, close, bonding daily and seeing each other through good times and bad. All in all, a nice break.

At the conference, I was fortunate to meet up with residency classmate Olivia Fondoble, and she considerately put me up for 1 night at her hotel, after a late evening event. Olivia's gentle manner and quiet and powerful sense of humor made for a memorable time. We also got to see med school classmate, Rob Hansen, whom my mother called Rob Handsome. Rob was also a non-traditional student in San Antonio, a wonderful, engaging, loving friend, and our entire families hung out together then. We also saw the fine folks at the American College of Physicians, who are, to a person, kind and good, and that was a treat. Faith Fitzgerald, an internist of formidable repute, has stayed in touch with me for some time, and has never acted like the grand poobah that she is. I was fortunate to meet some other folks, whom I jelled with almost instantly, and look forward to staying in touch with.

We drove back from Toronto, and got grilled at Immigration again. As we waited in the car, in line, I wanted to eat the lunch that the Poppens had packed for us and Scott vetoed it; just as well, because the tandoori chicken on my breath might have freaked out the Immigration chappie. We got to Indianapolis safely, and I went to work this morning for St. V, seeing all my former colleagues again, which was magnificent - lots of squealing, plenty of hugging.

I have never been stressed about travel, but I will breathe easier when Naren walks through the doors at Chicago airport. We have been in touch almost daily, and I think he knows how much I value safe travel. What did my parents go through as we left their doors for places far away, to study or work?

There have been many occasions recently when I have been grateful for my mother's ways. She did not overtly teach, covering her abundant love with a business-like approach, and taught more by example than prattle. I do know now, though, that we were her life: she cooked, sewed, mediated, doctored, taught, entertained, disciplined, loved, sang (very well), danced, drew, painted. We ate her delicious cooking without saying anything; when my gentle husband married into the family, he complimented her cooking routinely and she loved it, often asking him especially if her meatball curry was good, or her stew was tasty, and then urging him to voice it if they were. We never found favor with whining about our friends, and especially not our in-laws or our spouses; she would certainly listen, but the message was clear that in-laws were our husbands' families and that it behove us to get along. Amen. I never heard my mother and paternal grandmother argue; instead, both appeared to be very comfortable in each other's company. So much easier to get along, and to appreciate differences, and to love and laugh; I think it is especially nice when the children know their relatives and can see their strengths for themselves. Her sense of humor, which the boys mention, I miss also. Most of all, though, I am thankful for the fact that she treated everyone with grace and exhibited a lot of class in all her interactions.

Unw -

R

Report of 18 April 2010

2010-04-18T07:07:00.000-07:00

Hello from West Memphis, Arkansas -

I like travelling here. We spent the last few days with beloved friends in San Antonio, and I spoke at my old school. That talk took a little warming up, on my part; there were new pics of our impoverished, destitute Banyan patients and I thought I rambled a bit. There is a lot of interest at school in free clinics, etc., and I suggested that the enthusiastic young folks charge at least a nominal fee for services, as there is absolutely no appreciation for said services otherwise.

We were fortunate to see former neighbors, Gaby and Lamont, the day we left, and met them and Aurora for b'fast. Aurora cooked, and we filled our stomachs before heading out for Indy. I also feel lucky to have seen former professor Greg Freeman; some of our patients at the Banyan have died in the recent past and as I don't have access to post-mortem, I have to take a best guess at the causes. Greg, a cardiologist of considerable skill, and I discussed the issue in detail, and I have some more clues for prevention and management. I tell you, I completely enjoy being in touch with former profs. Both Linda Johnson and Greg Freeman gave hefty checks for our work in India and that was oh-so touching.

My sister, Anu, is in the U.K. for a meeting, the meeting is over, and she is stuck due to the volcanic ash grounding flights. I feel fortunate that we got here before the groundings. My family at home and I are in regular contact, and I appreciate that tremendously, especially after hearing of other friends whose family relationships border on the acrimonious.

We will be in Toronto next week for the conference of the American College of Physicians, annually a grand show. So much learning packed into 4 days - I like it. We are hoping Naren's flight into the U.S. is as scheduled; Navin mentioned that today. This is the first time that our trip has been staggered thus, and we are hopeful that Naren will join us safely.

Nice to be here. I pigged out on sausage biscuits and gravy this morning - vintage Southern fare - and am sitting here in a sated haze.

Unw -

R

Report of 15 April 2010

2010-04-15T12:57:00.000-07:00

Hello from the United States -

Tax day today. I look at all the benefits of this taxation - good roads, potable water, affordable food - and I think any country that takes such good care of its citizens is quite worthy.

We flew on the early morning of the 12th. Sitting together is not guaranteed any more, and we had 2 aisle seats, plus one seat across the aisle, which actually worked out very well. Navin was grilled in Frankfurt - "Where were you born? What will you be doing in the U.S.? What is your mother's maiden name?" - and that was a little unnerving for him. The grilling was not unexpected at all, because both boys look Middle Eastern and are in an age group of much interest, and I knew they would be questioned. I was relieved we were alongside, and now I won't rest easy until Naren makes it safely in. The usual tough questioning at U.S. Immigration in Chicago also ensued - "What are you doing in India? What's a medical missionary? How can you afford to do that?" - and this is completely par for the course, but bugs many people when I narrate it, because I am legally entitled to be in this country.

I was dreading flying United, connecting from Lufthansa, but they were great. The flight attendant got us some extra snacks because we were starving. Navin's vegetarian meal came quickly, and he ate well. We were picked up in Chicago by our wonderful friend, Colleen Taber, and we got to the Taber residence comfortably. Dinner that night with the very friendly Mark, Christopher and Colleen Taber - pizza. Navin ate his with an expression of sheer rapture: pizza is an unaffordable treat in India.

Jan, my mother-in-law, came up to Indy the following day and helped us rent a car. That was extremely considerate. We hit the road for Texas, and are here now. I speak at my alma mater tomorrow, and look forward to it. Navin helped me finish the talk, and I am grateful for all with tech savvy. We are staying with former professor Richard Luduena and his wife Linda, and their home and hospitality are fabulous. All feel tremendously welcome, and are relaxing. Navin has gone to see his beloved friend, Arwen Freeman; her mother Aurora picked him up, and we will see all the Freemans tomorrow. We see Linda Johnson, another former professor, for ice cream later tonight, and look forward to her geniality and sense of humor.

At my pre-employment physical 2 days ago, I filled out the medical questionnaire asking for family history, etc. That got a bit difficult, as the change now is that my mother is deceased. I think my mother's passing will continue to manifest in many ways. I now wear a chain that used to belong to her, and I do a double take every time I look in the mirror.

Hope all of you are well.

Unw -

R

Report of 5 April 2010

2010-04-04T22:10:00.000-07:00

Hello from Chennai -

Butler is in the finals of the NCAA basketball tournament, and I am very excited about the sporting contest. I love watching sports and it is at this time that I miss TV. We hope to find the game at a friend's house. In reading up on the game, on the Internet, I found ads for "Hooters basketball," and buxom scantily-clad women advertising something. It's good that I came upon this; my mindset has to alter pretty quickly to accommodate U.S. mores. When our beloved and talented A. R. Rahman won a Grammy, the photo of him at the awards ceremony showed him in plenty of clothes and the presenter in not-plenty-of-clothes.

The Banyan is doing well, and our patient who had a massive stroke, Ms. SA, is now tracking with her eyes. This is her 2nd stroke, and I'd thought it was insurmountable, but after this eyes business, I have requested the physical and occupational therapist to do intense exercise. I hope for some recovery. Ms. SA's family does not see her, and we are happy to fill in. We paid for the Banyan residents to have a meal, in my mother's memory, and I'd requested "non-vegetarian food," a special treat in our organisation. All had an egg with their meals; I'd hoped for chicken or fish, but I guess that could not be arranged, either for financial or other reasons. I know the residents had been praying for my mother, too, and my mother would have wanted them to eat well.

We spent the weekend in Madurai with my father - yesterday was his b'day. My sister, Anu, had gone the previous weekend, and my sister-in-law Susan, niece Sanjana, brother Vinu, Scott and I met in Madurai this weekend. It was fun. It was Susan's first trip back after my mother's demise, and she was overcome by emotion at various times. The will was read; it is handwritten and brings back nice memories of my mother. Apparently, handwritten wills are the most valid of all, and my father said they hold more water if they are not contested. All of us gaped at each other, wondering who'd contest. It is nice to be in a family where we value each other more than we value bank accounts.

Susan and I tried to clean out various closets that my mother had stored things in. Some of that we got through; her nighties and duster coats were divided, and many boxed up to be given to charity. My mother's sari cupboard was more difficult: so many beautiful saris, each evoking powerful memories of my mother. We took what we wanted, and locked the cupboard again. I figure we'll try again in a couple of months. I brought home a robe my mother used often, and now looking at it brings back strong memories, along with the stark realisation that my mother is not here. I put the robe at the back of my closet.

It was nice to hang out with the family. We overate, and talked and laughed. Especially laughed. It was good, and therapeutic. I feel like there are a lot of people leaning heavily on me, and feel sometimes that I don't have enough strength for all; thus, laughing up a storm on the weekend helped immensely.

Unw -

R

Report of 29 March 2010

2010-03-28T20:38:00.000-07:00

Hello from Chennai -

Go Butler! The Indianapolis college has made it into the Final Four of the National Collegiate Athletic Association basketball tournament in the U.S. We do not have a TV, but hope to watch the games next weekend, if someone televises them internationally, at a friend's house.

The Banyan goes along swimmingly. There is a young assistant, a patient now employed at the B, in the sick room. Ms. M.u. cleans and helps out, and generally makes herself useful. Our residents' files are very thick and full of papers, and require considerable skill to open them. After I have finished writing in the file, I hand it over to Ms. M.u., and she flips all the pages back and closes the file. At the completion of each file-closing, she draws my attention to it like a child, and I then rave about her efforts. Her smile then is a picture of accomplishment and self-satisfaction; a job well-done does give the doer a lot of confidence, doesn't it. This job is simple - close files - but the amount of Booster Hormones it gives Ms. M.u. is a treat to see.

How fortunate are we, eh, that we can so charge a young lady's self-esteem with the simplest of means.

There is a young woman at our administrative office who is contracted to clean. She had asked me for my sons' outgrown clothes, as she has 4 children (3 boys); this number of children prompted a discussion between her and me, as I push for smaller families *especially for those who cannot afford large ones.* She has variously seen me "curb-side" for rashes, or fatigue, or cough. Today, she told me that she could not catch her breath all night, and coughed when she lay down. I examined her, detected a faint wheeze, and told her she needed an inhaler for such times. She shuddered, said she could not afford an inhaler, and asked for some "pills," instead. Her colleague told her not to think of the cost but of her health, and educated her about the benefits of an inhaler. Sometimes, my best allies are those affiliated with the patient; I can drone on about the medical benefits of the treatment I prescribe, but a few choice words from a lay person often help much more to convince the patient.

The 3 Weiss men are well. Naren has exams this week; non-professional courses in India are very easy, and exams are generally not difficult. Navin has gone out of town with his school, and they will visit some villages with economic hardship, so that young minds can see challenges that our fellow citizens face and perhaps come up with some solutions for them. I like such trips. Scott is well, and losing weight in this high heat; there was not a whole lot of weight to start with, and now much of that is going as well, so he looks emaciated. One of my mother's goals used to be to get Scott to gain weight, and she acknowledged his high metabolic rate as a challenge there.

Nice to get along with one's in-laws, isn't it.

Happy Easter to all of you!

Unw -

R

Report of 22 Mar '10

2010-03-21T20:25:00.001-07:00

Hello all -

Exactly 4 weeks since my mother passed away. I find it easier to remember when she was ill, for then I can remember her passing as merciful and a release. I can't yet dwell on the good times, because then I might start missing her. All the condolences shared with us by those who knew her mention her directness and honesty. Scott and the boys remember her sense of humor and her great love of making faces at my father.

So, I have glasses now. I noticed that I had to start holding printed matter farther and farther away from my eyes, and took myself off to my schoolmate (from 10-year-old days!), D. Ramesh. He is now an opthalmologist of considerable calibre, and our family ophthal. Initially, only Naren and Scott were his patients and now I. D, as we call him, and we had a long conversation before the medical part of the appointment started - discussing parents, death, medicine, the medical system here and in the U.S., Obama, illnesses, etc. He then examined both Scott and me; Scott's vision is maintaining, and I need reading glasses. D gave me a pair, and I quite like them: they magnify the print, and I no longer need to hold things far away, or sit far back from the computer's monitor. On flights last year, I had to watch the TV of the person in the row in front of me, as I could not focus on my own, however back I tilted my seat. D also told me I had to wear the glasses low on my nose, and then look over them at people talking to me, or other things I might want to see. That is a bit of a challenge, but it is a bearable one.

I got back to work at the Banyan last week and it is mighty therapeutic. The senior health care workers came and talked for quite a while with me; our bond is strong - we are on the providing side of the medical world, and I think they know my tremendous respect for them. There were patients to be seen and psychoses to be dealt with, and at least one violent person in the sick room. As I looked at Ms. A, and the disruption she was causing - from not letting me see her bed sore to using rank profanity - I thought to myself that I was very glad she was at the B, and not somewhere where her actions would provoke ire, or violence, or misunderstanding. How fortunate are we that we can take care of those whom others absolutely will not, or cannot. In a brief moment, the senior health care worker did manage to expose Ms. A's bed sore, and it is healing well. I was also very pleased about that.

Ms. M, the very cheerful patient who always smiles very widely when she sees me, came by the computer terminal where I was working (about 8-10 of us have to share this machine) and beamed her beautiful smile at me. I was delighted, and stood up to ask how she was, whether she had eaten, etc. That is the extent of my Hindi, but we revel in each other's company, and don't much care which language we are speaking in - Hindi or Gestures.

I have started to get very irritable. Maybe that's a form of grieving. I have low tolerance for repeating myself a billion times, and for clutter. Our apartment is far from beautiful, and that is irking me. The daily exercise helps immensely, as does music.

My sister, Anu, and family were in town yesterday and it was good to see them. They were off to see a movie, a treat for them as their small town, Vellore, does not have giant movie screens or English movies which play in English (they are dubbed in Tamil). Vellore is known for the medical college and hospital where Anu and Benji work, and several industries have come up around those: schools, hotels, restaurants, pharmacies. I found it to be a sweet little town with friendly people; I imagine that those who live there might occasionally want to see a non-dubbed flick, or eat multi-grain bread, or do something that those of us in Chennai take for granted.

I saw my friend, Joan, last week and that was therapeutic. Joan and I were in college together; she lost her father early, and her mother raised 8 children ably. Her mother passed away 2 years ago, and Joan and I sat and talked about what that's like. We also ate a vat of tasty food, and she gave me another vat to take home. It was a nice afternoon.

Unw -

R

Report of 15 March 2010

2010-03-14T21:43:00.001-07:00

Hello from Chennai -

The last time I blogged was the day my mother passed away. I am back at work today, and worked from home part of last week. Not much is getting done by me today: it might be the lack of sleep, or something else. Scott and I talked yesterday when we had some time by ourselves in the house, and I said that I had had time to prepare myself for my mother's passing but grief hits at strange times. 4.30 or 5 PM phone calls instantly cause my heart to race with an unrealistic and irrational hope.

The Coorg ceremony was nice, and it was therapeutic to hang out with my mother's relatives, all of whom were intensely solicitous of us. It was fabulous to return to Chennai, and to resume the routine of kids, work, housework, etc. A couple of times last week, I made macaroni and cheese, which is a great favorite in our house. It is actually a dreadful dish, and I don't eat it, but the men devour it and I was happy to make something they enjoy.

On Saturday, we had dinner served to the employees of the Banyan, who had been praying for my mother twice a day. My friend, Joan, owns a hotel and their kitchen catered the meal. I was particular that meat was served, as our impoverished employees can simply not afford to eat it otherwise. Meat was indeed served, and ice cream, and good things, and the meal was delicious; all were dressed well and ate to their hearts' content, they said. I was very pleased, as my mother would have been, to see that. We were privileged and happy to have the distinguished company of both the founders of the Banyan, Vandana and Vaishnavi, and I told the boys to remember that they were in the presence of icons. The boys adore both young women, and a nice evening was had by all.

I was delighted to have the family together; we went to listen to some live music, ate out at a burger joint, and caught a couple of Tamil movies over the weekend. I love the fact that both boys are getting more fluent with Tamil, and adopt street slang with ease. Naren turns 19 today, and there is a chocolate truffle cake (made by our favorite bakery which trains underprivileged young people) at home with his name on it.

There have been patients coming and going by our house, and the B, and today, at least, I dispensed medicine in a daze. Perhaps things will improve as the days go by.

If you have people in your life that you cherish, please tell them.

Unw -

R

Report of 22 Feb 2010

2010-02-21T19:50:00.000-08:00

Hello from Chennai -

Updating the blog was on my list of things to do, for sure. I have received news that my mother is worse. This state of affairs is precluding any accomplishment on my part. But work must go on, mustn't it, as must life.

Sometimes, overwhelming evidence is difficult to overlook. I am a medical person, and must not overlook it. Certainly, hope springs eternal, and we can ask for acceptance of the reality, not for unrealistic and improbable things.

Parents are unique and tolerant beings. The amount of stuff I pulled, especially as a teenager, had to be seen to be believed. In my mother's infinite grace, she has mentioned none of it to my sons. I have, in vivid detail, but she has not.

Thank you for your prayers. I think they have sustained my mother, and all of us.

Unw -

R

Report of 15 Feb 2010

2010-02-14T20:50:00.000-08:00

Hello all -

Belated Happy Valentine's Day. I recall buying chocolate on this day, actually, when everything would be 50% off, and Scott could give me a heart-shaped box of chocolate (long a lure, since seeing it in American comic books - you know, Archie gives Betty/Veronica, Richie Rich gives Gloria, etc.) without it breaking our bank. I would also load up on chocolate to be taken to India, where no one would care about eating heart-shaped chocolate in June.

We are dealing with my mother's critical illness and sometimes, it is very difficult. My stomach plummets every time the phone rings, and I start making deals with God for an extra day with my mother - "Remember when I stopped to put the blind man on the train, do you think you could give me an extra 24 hours for that?" Mostly, though, I look at my beautiful mother, her still perfect nails (no paid manicure for her) and marvel at how she raised 4 of us without letting our opinionated selves get to her. I am, actually, the least opinionated of us - believe it or not.

So, the Banyan goes ok. Just now, I had to send a patient to be evaluated for irregular menses. She might be approaching menopause, but I'll let the Ob/Gyn decide that. My patient appeared grateful for the referral, and it continues to puzzle me that (especially impoverished) patients act as though I've done them a colossal favor, when in reality it's just my job.

We spent 3 days in Vellore and came home. It is quite lovely to be home, and I will never again take regular routine for granted. The 3 Weiss men and I made a giant fruit salad yesterday (one of my favorite foods) and had a leisurely, 3-hour breakfast - with 2 hours of talking. It was fabulous. We talked about a touchy situation that we had undergone in Vellore, and both boys had excellent perspective on it. Navin studied for a math exam, Naren hung out, and we tried to watch the new "Taking of Pelham 123" that I'd given the men for Valentine's Day, but it did not work due to area restrictions. Naren is in the play "Moulin Rouge," and his producer, an extremely beautiful 28 year old lady, tragically committed suicide 2 days ago. My sons talked to us a fair amount, and I was glad for that.

I am grateful for all the prayers. I started reading the Bible in the ICU and have enjoyed it.

Unw -

R

Report of 8 Feb '10

2010-02-07T20:08:00.000-08:00

Hello from Chennai -

Routine feels good. Get up, exercise, go up, get men to breakfast, etc. We had hoped to watch the Super Bowl today, but ESPN was not showing it. Our neighbors looked for it on their TV (we don't have TV), and could not find it. As it turns out, the New Orleans Saints have defeated the Indianapolis Colts for the title. Though all of us did support the Colts (I did residency in Indianapolis), it was good that a city which got almost wiped out a few years ago had something to cheer about in their team's win.

My mother is stable. Yesterday, Anu phoned me and put the phone to my mother's ear and had me bellow. It appeared that my mother understood what I was saying. We will see her on Saturday, in Vellore, which is about 2 hours away from here. My father had told me not to punish my son very harshly for his shenanigans, which is quite what my mother would say.

I got to talk to some close friends, all of whom know my mother from college days. That was extremely nice. During college, my friends and I were in and out of each other's houses, truly, especially if some special food was being made. Friendship in India is very profound, often involving the whole family, and a lot of my friends' parents are my parents' friends, too, and were party to all the eating. Thus, I have eaten fried rice and onion pachadi at one friend's house, fish curry at another friend's, murukku at yet another's, etc. My mother baked very well, perforce from scratch ("Cream the butter and sugar together well, otherwise the cake will not be tasty"), and friends would make a beeline for our house when cake was on the table for tea.

It took some juggling to accomplish everything in Madurai - be with my mother, stand by my father, get the provisions for the house, plan the menu, get everyone to the hospital on time - and I was grateful for all the help I could get. My sister and sister-in-law were there, as also Scott and Vinu. Vinu and I are very close, and it was good to have his weird sense of humor around. It is always good to be able to laugh, even - or especially - in stressful situations.

Colleagues at the Banyan have been very warm in welcoming me back. The able senior coordinator of Adaikalam, Vanitha, says the residents' prayers have special powers. I am starting to believe it.

It was wonderful to get your emails. They helped boost my spirits many times.

Unw -

R

Report of 25 Jan 2010

2010-01-24T18:50:00.000-08:00

Hello from Chennai -

One's thoughts get addled when a parent is sick, don't they. There has been no focus on anything else. I was in Madurai last week to go to the cemetery. The anniversary of my brother's demise is 26 Jan, and I cannot usually go on that date, especially if it is a weekday. 26 Jan is Republic Day in India, and a national holiday, but travel is usually difficult on that day. So I went on the 22nd, and put a garland of roses on my brother's grave, and remembered the robust, handsome, loving young man who was my brother, whom I got closer to as both of us married and had children, as we went through some similar life experiences, as we sat and snarfed chocolate.

My mother remains confined to bed, though I had her sit in the wheelchair for a couple of hours one morning, and she complained bitterly through it. I explained the new bed sores on her body, and she understood for a bit. My father had pulled an arm muscle, likely in caring for my mother, and remains in some disability. I was only in Madurai for the day, and my father uncharacteristically voiced disappointment; usually he accepts my plans for what they are, and is unfailingly grateful for the effort made to go and see them. I think he is getting exhausted, however. And my mother is ill, "sundowning" with regularity. "Sundowning" is a state where a person's mental status gets altered in the evenings. My mother does not quite know where she is at that time, and speaks irrelevantly. It is a bit difficult to see, because this was a vibrant, classy, sociable and extremely funny woman in her heyday. We are planning to shift her to Vellore next week; Vellore is where my sister and brother-in-law live, and there is an outstanding hospital (Christian Medical College and Hospital) there, where both work. My parents are listed as my sister's dependents, and will get free care at CMC.

There are dogs at the Banyan - both the founders, Vandana and Vaishnavi, are dog fans - and there are 2 around me now hoping for some food.

The Banyan continues well. I was fortunate to have a meeting with Vandana last week. She is 39, founded the Banyan 17 years ago, and is a very visionary, engaging, gregarious, funny, warm, loving human being. We have had raging arguments as well - both of us are intensely opinionated - and she is a fun person to work for. As I often tell her, she did not hire me to keep my mouth shut, and she agrees wholeheartedly. The B's abject lack of money does not bother either of us too much, as the work will go on.

On other updates, the young woman who had been sans a menstrual cycle got evaluated at the center I sent her to, and has started her period, to everyone's great joy. Little Ms. S, the impoverished schoolgirl, now goes to school regularly, says Swapna. Our triumphs might seem small, but they are mighty.

On Saturday, we went to visit a village that Scott's company has sort of adopted. Scott pays for a little boy's school supplies, and we met the child, M, at his school. It was great! Mr. M started out shy and quiet, but warmed up as we went along, and played ball with Naren and Navin. They managed to get a smile out of him, even. Naren quickly walked M to his house to put his gifts away, worried about the bullying by older children; M assured us, though, that the older kids would not yank away his gifts, and we were pleased. Scott's colleagues had taken chocolate, laddus (laddu is a very tasty Indian sweet) and pens for all the school kids, and it was a treat to see the kids line up and glow with absolute joy as they got the goodies. The lead organiser from the company is trying to get more employees involved in this effort; I see now that money exists for all causes, we just need to know where to find it.

Please drop me an email if you can. My head spins with regularity, and I welcome contact from friends near and far.

Unw (Until next week) -

R

Report of 18 Jan 2010

2010-01-17T21:04:00.000-08:00

Hello from Chennai -

Sometimes, days of the week tend to blur, don't they. We had a four-day weekend last weekend, and managed to get going on time to work today. Quel surprise. We have mosquitoes in our bedroom in spite of netting at the windows, and I didn't get very much sleep. As I take the train to work on Mondays and Wednesdays, I wasn't too fussed about being too sleepy to drive. I love living in a city with public transport.

Last week was Pongal, the harvest festival. Sweet rice (with jaggery or brown sugar) is made, new clothes are bought, the Gods are worshipped to thank them for the harvest and to request their assistance with the next one, and sugar cane is eaten. I went to work on Pongal, and a patient died at the Banyan. She had been slightly drowsy the previous night, I understand, and then her heart stopped the next morning. I do not know how long that had been before she was found, but I noticed a faint, thready pulse when I checked the young lady, and then it stopped; we started CPR, and worked fairly feverishly to save her. This is a patient who has bantered with me before, and laughed, and joked, and as I looked at her still form, I tried to will some life back into her. That did not work, and then she was rushed to the hospital; I wondered if I had stopped CPR too soon. She could not be resuscitated at the hospital, and I miss her very much. I think of her laugh, and her manner, and I hope I do better for the next patient.

We have no way of getting a post-mortem without casting blame on someone (that's the way the system works in India) and so, I will never know why Ms. AK died. That is very frustrating: there are countless lessons to be learned even from death, and these are denied to us. If there are some causes that can be prevented in young people, or even old, I will not know of them and cannot do the best job I can in the prevention arena.

I am, however, grateful that Ms. AK was with us for a part of the short time she was on Earth, that she was well-tended and cared for, loved and indulged, clothed and safe. A much better option than being on the street and dying surrounded by indifference.

The weekend was spent bonding with the men. Naren's college, MCC, was in a theatre competition, and we saw it. Each college had to present a Shakespeare play in 30 minutes. The entire competition was good and MCC won "Best Play" and "Best Director." Naren and his friends, Karan and Samyuktha (the director), wrote their version of "Julius Caesar," and it was cool. Naren played Antony. The overall trophy was won by Sriram Engineering College, with a very unique play done entirely by miming. They were riveting.

Vandana, one of the founders of the Banyan, took several of us to see "Sherlock Holmes." We loved it. Guy Ritchie is an edgy director.

I'll wind up now and hope for the best for all of you.

Unw -

R

Report of 13 Jan '10

2010-01-12T21:09:00.000-08:00

Hello from Chennai -

I feel like I am standing here with my arms outstretched, and several winds are blowing through me. It is a slightly frustrating feeling, and yesterday, I sat the 3 Weiss men down and requested them to carry out their responsibilities themselves, and not get on my nerves too much. The boys very sweetly thanked me for my candor and stated their willingness to try to comply; one said he thought he might not succeed completely in staying off my nerves, and that candor was welcome, too.

My mother is now home, and refusing to get out of bed. She states that getting up causes pain, and who are we really to question that. However, I feel that getting up is mandatory to avoid all manner of complications, but accomplishing this is Herculean. If all of you take one thing away from here, please make it that a daily 30-minute walk now will avoid many disabilities later in life.

The Banyan is great, and it is nice to be here. One of our ladies fell, and her thigh bone, a bone that is usually very strong, is now broken. Our impoverished ladies have brittle bones (osteoporosis) and I have attempted mightily - daily calcium, weight-bearing exercise - to prevent complications, with varying results. I loathe preventable illness, and maybe someday will achieve goals. For now, though, a daily 30-minute walk has to suffice.

Some magnificent interactions last week: my aunts are visiting from Mysore and Coorg, and we have got together with them. Their senses of humor are legendary, and it is a treat to be with them. They took us out to eat yesterday, and all of us pigged out. I also got to talk to Hema, whom many of you have heard from (she runs the Friends of the Banyan group in the U.S.), and that was like salve: Hema is a gentle, fun, easygoing person, totally committed to helping the Banyan, and we had a great chat. I received an email from a former patient in Indianapolis, a gentle person with a wonderful sense of humor and engaging manner: Mr. W stated that he was doing well, and was still managing to stay off alcohol. I was delighted! I attended Navin's sports day, and that was great: I love watching live sports in all forms.

I am very pleased and soothed at receiving emails from friends. Sometimes, a kind word or two can go so far, whether the communicators are closeby or far apart.

Unw -

R

Report of 8 Jan 2010

2010-01-07T18:42:00.000-08:00

Hello and Happy New Year!

I haven't written in a while and have sorely missed it. Like communicating with friends.

It has been an exhausting couple of weeks. The Weiss men and I spent Christmas in Madurai with my parents and extended family. My mother had just been released from the hospital after a mild attack of dengue, mild but affected her mental status quite a bit, as illness will in older patients. When she was home, she refused to get out of bed and all activities were done lying down. It took considerable coaxing for her to consider the wheelchair, and one day, when she mildly agreed, Scott and my brother-in-law, Benji, quickly lifted her up and into the chair. That was good, and all of us then sang Christmas carols and prolonged the sitting position. So many things that my eminent professors taught me - about illness in the elderly, the need for constant support, the importance of nourishment and mobility - bore out with my mother. Scott was magnificent in coaxing her out of bed, and endured her illness-induced irritability with grand grace. (My mother is, otherwise, an exquisitely classy person renowned for her hospitality.) It was, of course, wonderful to see my sibs, sibs-in-law, nephews and niece. We ate, talked and laughed, and mulled over what we'd be like in older years.

We returned from Madurai, and the 3 Weiss men and I went to Orissa for a holiday. It is like salve to be with the men, and I like being able to bond thus. Our country has a rich, ancient civilization, and it is a joy to see it and know it; however, many heritage sites are dreadfully maintained and difficult to access. We try, though, as I like being able to see this magnificent history, and I like the men to see it, too. The Sun Temple in Konark is a UNESCO World Heritage Site, and after we went there, I could see why. Hooo! There were explicit sexual positions of all kinds displayed in sculpture form all around the temple, some life-size and some smaller. It then became something of an odd hunt to find out what else we could spot in the small sculptures. Naren and Navin could not believe their eyes, neither could we actually, and all realised the truth that Hinduism really does worship the sexual act. The book "Kama Sutra" originated here. Other than the Sun Temple, the other temples did not permit non-Hindus to enter, and all make an assumption on seeing Scott, the white guy, as being non-Hindu, whereas he is a devout believer. We stayed in a nice hotel, discounted for us through an acquaintance, but did not eat there; instead, we found a sweet little eatery walking distance from the place. The food was extremely tasty and the price so reasonable that we ate there daily, made friends with all the staff, got an autorickshaw organised through them for local sight-seeing and all in all, had a memorable time. The manager, in particular, liked Scott immensely (not hard to do), and said he would come and see us in Chennai, which we welcome. Orissa is a militantly Hindu state, with non-Hindus coming to all manner of harm, and we did not see many non-Indian tourists about. While visiting there was nice, it was lovely to come home to our beautiful, safe Chennai.

On return, we found that my mother had been re-hospitalised, and I went to Madurai. My father had stated that no one need go, but he appeared grateful for my presence. I did not intend to quiz any of the specialists involved in my mother's care, but my father routinely unleashed me on them. This was also a chance to have great conversations with my witty father, and we talked at length. My mother's mental status waxed and waned, concerning me greatly, and it appeared to get better when she ate more, and got out of bed and into a wheelchair. St. V geriatricians, Diane and Patrick Healey, sure taught us well. I did what I could in Madurai, got a bit exhausted, and returned to Chennai. There is now full-time help appointed to take care of my mother, and plans are afoot for both my parents to move to Vellore, where my sister and brother-in-law live, and where medical care is free for my parents, being my sister's dependents.

In Madurai, the sweeper at the hospital finished cleaning my mother's room and asked me why she (herself) was breathless. I did a quick exam, found she was anemic, had a heart murmur, prescribed iron replacement and referred her to a specialist. She then touched my feet in gratitude/respect, which I felt was unnecessary. I chuckled about this to my father, and he said that the young lady was of the "Scheduled Caste" or an outcaste ("Untouchable"), that no one was to touch her and that she likely appreciated the fact that I *touched* her. Really, some things - such as untouchability - in my beloved country are remarkably stupid.

It is lovely to return to the Banyan, and do what I can for those whom others will not care for. I increasingly feel the presence of a Supreme Being, especially as I look at Ms. Ma and she smiles her beautiful, contagious smile and takes my hand.

Please feel free to drop me a line or two. It would be nice to hear from you as I deal with several issues concerning my parents, and myself.

Happy New Year! I wish for you good health and happiness, and am inordinately grateful for the chance to be in touch with you.

Unw -

R

Report of 21 Dec '09

2009-12-20T20:05:00.000-08:00

Hello from the Banyan -

Greetings of the season! May the true meaning of Christmas, replete with peace and joy, stay with all of you throughout 2010.

The week has been alright. Patients healing, the Banyan thriving. We have had some luck with the residents escaping gastroenteritis of the monsoon, thank goodness. The rains continue, though, and I am hopeful of the best. One of my colleagues, who is from a village nearby, said that it is customary for rains to last from Diwali until Pongal (the harvest festival in January). Wow - I had not realised that at all.

Our patient with the broken arm has been advised conservative management instead of surgery. She is HIV+, and it is not surprising to see many surgeons decline to operate on HIV+ patients. This saddens me considerably, especially since a dear friend from med school is now HIV+, and I would not want this discrimination foisted on said friend. I honestly do not know if surgery is indeed necessary, or if the conservative management has been advised due to HIV status, and I have asked for a 2nd opinion. I'll find out the answer this week.

Update on the school kid: after a day of balking at going to school, she is now going regularly and happily, Swapna mentions. We need the girl children educated, I tell you; for that matter, we need all children educated, however educated girls tend to make much more sensible decisions that would haul them out of poverty, and keep them somewhat free from violence and a zillion pregnancies. So young Ms. S going to school is our Christmas gift, and we are happy for it.

The ladies who help us (Weisses) clean the house and cook appear to be getting some sort of reputation in their neighborhood about being helpful sorts, and they asked if I'd see one of their neighbors for a medical consultation. The young lady is 17 years old, a school student, and has not been getting her period regularly. So I saw her at our house, asked that she and her mother sit down (not usually offered to the "lower caste" by the "upper caste," which is too funny/ludicrous) and examined the girl. I then referred her to a nearby Public Health Center where another patient of mine had been; that young lady was well-treated, with appropriate care and the requisite dignity and respect, thus pleasing me greatly. I told the mother not to worry, that the condition was correctable, and to let the other doctors work their magic. The patient herself was unafraid and forthright, and spoke some decent English, and I was happy to see our education system at work.

Some fine times last week. We were invited to Naren's cast party, went, I danced, and we had a great time. Our friend, Anita Sigler, came into town and spent an afternoon with us; that was jolly good fun. Anita also came loaded with goodies, intent on spoiling everyone, and a grand time was had reminiscing, speaking of life as wives and parents, and laughing a bunch. We had dinner at the home of the new Banyan CEO, David Nash, and his family. They are from the U.K. and were originally going to serve South Indian food; I begged for a menu change, being a big fan of non-Indian food, and so we ate British food and it was deeee-lish. David, Kate, Naomi and James are gracious hosts, and young 10-year-old James had made a sinful dessert which all fell upon.

We are off to Madurai this week if train tickets permit, and will celebrate Christmas with my disabled mother, recently discharged from the hospital after dengue, and my father. The rest of the mob will gather as well, and we look forward to that.

The 3 Weiss men and I hope you have every gift of the season, especially peace, joy, lack of war, full bellies and non-leaky roofs.

Unw -

R

Report of 14 Dec '09

2009-12-13T18:52:00.000-08:00

Hello from the Banyan -

First of all, my deepest apologies. I don't usually beg for bucks for the Banyan or anyone else through my writing; I usually give a contact in case anyone wants to donate. However, this past week, matters changed. As an updated wish list for the Banyan was put in place, the able coordinator of Adaikalam (our residential facility housing 250 mentally ill, destitute women), Vanitha, mentioned that a pipe had broken and there was no money to repair it. Vanitha might be 30 years old at the most, and has been a senior coordinator for a few years now, that's how capable and passionate she is. She and I stepped out to take a look, and stared up at a spot about 20 feet off the ground where a pipe had developed a break and was spraying liquid. Not very much fazes Vanitha, and we resolved to do something about it posthaste, thus the desperate email. We are desperate. Vanitha and I could go home to our families after a day's work, but 250 destitute women and 30+ staff had to stay on in a compound that had sewage stagnating on one side. So the frantic appeal was sent out, and thanks to all those of you who could help. I understand completely if you cannot; the economy cannot really offer a lot of extra bucks for charity.

Life is fairly one constant episode of busy-ness. I haven't read in a while, I haven't managed to finish the daily newspaper - a requirement for me. However, I work in a place taking care of those others would spurn (does the Bible not say something about this?), I have a husband who does not beat the tar out of me, I have sons that are steadily inheriting the desire to change life for those who are afflicted by poverty, I have relatives (on both Scott's and my sides) who maintain relations with me, and I have a roof over my head that does not leak. These are, by golly, great blessings.

Ms. Ma with the happy smile and the back pain is better! I had asked that an analgesic cream be massaged into her back, and that appeared to have improved matters. Ms. Ma does speak a little Hindi, and comprehends well though her speech is stilted; when I asked her how many idlis she had eaten one morning, she held up 3 fingers and said, "Theen (three)." So she does comprehend, and does communicate. I looked at her intake history, and there is no mention of her family. Either she could not tell us their details clearly enough, or she does not know them. We do not know if anyone is looking for her; I regretfully suspect not. She is mentally ill, might be mentally challenged, cannot communicate conventionally, and some families view such folks as huge liabilities. But they haven't seen this smile, and the way she takes my hand and leads me into the sick room, and her earnest manner in answering me when I ask about her breakfast. I am not a huge believer in God, for various reasons, but looking at her and seeing her therapeutic place in my life convinces me as nearly as possible about the presence of a God.

I was fortunate to have an impromptu lunch at the home of my neighbor, Sushmita. I *love* eating others' cooking. I had finished using the Internet at her place when she offered me tea; I declined but said, "You know what, though, I am really hungry." She offered me lunch, as most folks will, and we ate rice and dhal and okra (called "ladies' finger" here), while her 5 yo and 3 yo played near us. It was inordinately good fun. Sush's maid, Ms. K, is a remarkable sort: having been abandoned by her husband (a not-uncommon occurrence here) a while ago, she has educated her daughters. Her older one is finishing up a degree in math, and the younger one appears to have a learning disability and has stopped school after 8th grade, now learning a trade. Sush's mother-in-law, Usha, a very dear friend and also a neighbor, had phoned me about the younger girl one day and described disabling belly pain. After some questions, I had to take a best guess, as I often do when I can't see the patient, and prescribed an anti-spasm pill; it appears to have worked, and the young lady is better. Ms. K was full of thanks, and I felt that was unnecessary: I had merely done my job and my giant reward was that my patient was better and someone with absolutely not one extra rupee or even an extra paisa had been helped. One day, Ms. K said to me, "There isn't even anyone to ask how I am," and I thought that was sad, and thought again about how much I had.

Some fine times last week - Naren's play was staged. Total of 10 performances, last 2 days on now. The first day was so-so, as is common in the world of theatre, but as the days wore on and the cast started to jell together and "feel it," the production turned into a magnificent, irreverent, funny and interactive event - a true pantomime. Naren sang and danced, enjoying himself, and we heckled him and others at times from the audience. The great joy for me was that one of the cast heckled back, and it was hilarious! All laughed at that, and it made my day. Naren wandered into the audience one day and danced with me. It was fun. The best part is that all the bucks from this venture go towards helping underprivileged children go to college, and that is a cause very dear to our hearts. Several beneficiaries return to help in the production, also warming my heart, and this year, we heard the news that one of them, now working, has been sent by his company to the U.S. Oooohhhh!!! What just rewards for the young man, how nice that Aysha Rau thought of Little Theatre to so assist.

My father was in town for some other event and caught the play, my sister and her family also joined us, and we had dinner at our house last night for all + my brother and a cousin. It was a fun time, and I was grateful for this bonhomie.

Unw -

R

Report of 7 Dec '09

2009-12-06T19:58:00.001-08:00

Hello from the Banyan -

When I joined med school, a senior who was married and a parent told us that there were some days we just would not read - kid emergencies, school activities, family matters might interrupt. I thought then that I would move Heaven and Earth to get time to read. Now I know what he was speaking of - this past week, my grand goal of reading professional material for an hour a day simply could not be accomplished: ferrying kids, school meetings, parent in town. All the activities were exhausting, but fulfilled my role as wife, mother, daughter, chauffeur, etc.

The B's server was not working this morning, as usual, so I could not get online and managed to take the time to read. I have taken to wandering around with a professional journal or 2 and squeak in some time to read.

I got some lovely wishes for Thanksgiving from U.S. friends. We remembered with great nostalgia the meal(s) at the home of our San Antonio neighbor and dear friend, Aurora. She would start the TG meal early, use our oven at will and to our great delight, and then call us when the food was ready. We took over, at most, brownies. An el grande pigout would result, and the 3 men still wax eloquent about it, rhapsodizing about each dish. Navin, who is trying fervently to turn vegetarian, said he'd make an exception for Ms. Aurora's turkey. :) Nice to have such friends, I tell you. We were thankful for several things at TG, including the fact that our Indy YMCA friend, David, has found a job.

There is a patient at the B, Ms. Ma, who is non-verbal. She has gestured that her back hurts, we have sent her for an xray, and there is no fracture. She continues to point to her back and grimace, and I have requested a second opinion on the xray. We need to listen to our patients, especially the non-verbal ones. Ms. Ma has the loveliest smile, which lights up her eyes and entire face, and I am the privileged recipient of it every day. As I looked around the Banyan one day, surrounded by women whose families do not want them at all, I thought to myself that we who work at the B were indeed blessed that we could take care of these ladies, provide them a safe harbor and a chance to redeem their self-esteem, and avail an opportunity to receive some wonderful smiles. I give Ms. Ma an extra wave every day, just to get the extra smile. Last Thursday, I was in a very bad mood due to Teenage Turbulence at home, and spent a bit longer with Ms. Ma, at the end of which I felt better.

What are we giving the Banyan patients? Little, compared to what they give us.

We were driving home one evening after picking Navin up from school, and there was an accident in front of us. I usually stop at accidents and render aid. Navin came with me to the scene, and we saw that a lady had fallen off her scooter. She had a gash on her head and seemed a bit distraught about events and a tad fainty, but overall, she was fine; not fine enough to ride her vehicle, I told her, but fine enough to go home and rest. This is the reason I stop: to give all those involved a sense of the true story, and try and ease some panic. I washed off her wound, and reassured her she was okay; she did want to get evaluated at any nearby clinic and I said that was unnecessary, but alright. Listen to the patient. As we left and got into the car, Navin said, "She should have worn a helmet." Bingo. We got out of the car again, went back to the scene and told her; she mentioned that she had forgotten the helmet due to being in a bit of a hurry due to her exams, and we suggested that she remember at all times.

My father returned from his conference and blew through town again, struggling with his asthma that had worsened due to the cold in Delhi. We got him at the airport and helped him and his colleagues board the train to Madurai. They had tons of luggage, and Scott, my slender husband with a strength that belies his frame, helped heave all the bags onto the train. He touched my Dad's feet, a sign of great respect in Indian culture, and my Dad got so choked up he could not speak. It is nice to have a husband who relates so well to his in-laws and to our culture.

We saw the movie "Ninja Assassin," as one son wanted to. It was at best, a B-movie, but I enjoy seeing fit people on screen, and the training process for martial arts, so it was not a total loss. The new goal is a hand-stand pushup, as the star Rain did onscreen; I have a while to go, yet, but the goal remains. :)

Naren's play is this week (a total of 10 performances) and rehearsals have been hectic. Navin has an exam this week and studying is on. Ultimately, what these boys make of themselves is up to themselves alone; we are grateful that they are unfailingly kind to those who have much less than them.

Unw -

R

Report of 30 Nov '09

2009-11-29T21:20:00.000-08:00

Hello from the Banyan -

This is when it's nice to work for an organisation such as this. I walked to work this morning from the train station, through the giant non-Tamil speaking slum. The weather is cooler, and the residents have brought out bedspreads and such to cover themselves. I walk through and get to Spur Tank Road. Huts and temporary shelters on the other side, and on the river bank, have recently been cleared; residents have had to find other accommodation. I see a tent and a young lady near it getting thrashed by some people; a man is beating her with a stick, a woman is slapping her on the face with her bare hand, people are crowding around, passing comments, one man takes the young woman aside to try and keep the beatings at bay. I am riveted; I can't leave, and can't really plunge right in to this issue, either. Oh, can't I - I stop and stare, and manage to catch the attention of the male beater. I gesture to him in a classic Indian manner to ask, "What?" We meet in the center of the very busy road, and the man says that the girl is refusing to go to school and has torn up her uniform so that she can't go. I ask him why and he says, "Obstinacy." I suggest there might be other reasons, that he should investigate them at the school to which he says "No problem at the school," and I implore him not to hit her. I ask what he would do if she committed suicide, a not-uncommon phenomenon among young people here. And then I go on to the office.

I sms a few people frantically, and Vandana suggests Swapna. Swapna comes to The Banyan Centre (TBC), and we walk over to the tent. The girl is sitting there, eating, and the man is asleep inside. The girl is actually much younger than she had earlier seemed to be, and might be 9 or 10. Tent? It is a piece of tarp, slung over a tree branch and weighted down on each side with boxes. Swapna is magnificent: she asks the man why the girl won't go to school, and he suggests we ask her ourselves. So we do, and the girl hesitates. We then offer to take her to TBC to talk, explain to the man and to some neighbors what we are to do, and Swapna suggests that someone come along if they'd like. A little boy is sent with us. His name is KR, and he is 14 years old; he looks 8. He states he has been made to stop school by his father, that he actually enjoyed school. Both kids attended a missionary institution near TBC, and no fees were paid, the kids got food and drink.

Swapna talks extensively to the child, S, and manages to extract that S is actually quite a good student, but does not want to study any more, she wants to play all day. Her inspiration appears to be KR, who is an extremely happy kid, conveying every impression that his school-less status has led to this jolly state. Swapna manages to convince S to try to return to school for a week, in which time Swapna will monitor progress. We then bring the father, P, over for an update, the kids eat breakfast at TBC and fill their bellies, and a kind colleague gives them some chocolate; they are elated and want some more. We tell them regular school-going will result in more chocolate and they go on their way.

Have we saved the world? No. Have we made P's world just a bit better? I think so. It is nice to work with like-minded people who will save individual worlds.

The Banyan is doing well. Ms. S, our HIV+ patient with the broken arm, has been given a trial of rest to heal the arm. It is in a sling. Ms. S cannot be contained; she takes the arm out of the sling at regular intervals to wag it about and gesture to sympathetic fellow residents; she describes some process to all, using both arms exuberantly. As I've said before, she speaks a language none of us understands, and feels the need to gesture to get her point across; she also cannot be made to comprehend the need to keep the arm still and in the sling. I discuss this with the team, and we say surgery has to be the option, "rest" is not realistic with Ms. S.

I continue my training for the health care workers and last week, we adopted the case discussion methodology. We divided the group into 4 teams and talked about what they'd do if they found a Banyan patient down on the floor and unresponsive. The discussions were magnificent! A lot of thought, insight, medical curiosity and avid discussion - these young ladies so want to learn.

Oh, some fabulous interactions last week. My sister, Anu, returned from Boston, bearing gifts from our friends, Nina and Benoy Zachariah, whose daughter, Roshni, just graduated from MIT. Lindt chocolate - mmm, mmm. And a nasal steroid for Scott, which he greatly appreciates. The Zachariahs are close friends of many years, and Nina's mother, Leila Kurien, is also a very beloved friend, whom we try to see every time we go to Madurai. A very dear friend of 30 years, Monica Cooley, came into town and we met yesterday. Monica used to teach us ballet at Lady Doak College, went on to learn Bharatha Natyam (a classical Indian dance), married Mahadevan and now lives in Nashville, teaching Bharatha Natyam to all interested parties. She also came bearing chocolate, and dried apricots; while I have waxed eloquent about chocolate, my true favorites (mine and Navin's mostly, the others tilting the preference scale towards candy) are fruit, trail mix and microwave popcorn. Thus, we knew who'd eat the apricots and who'd eat the chocolate. Monica and we sat talking for a long time, and it was fabulous: she is a delightful, gentle, funny, sweet sort who can totally relate to both cultures and laugh out loud about the idiosyncrasies of each.

We managed to see my father briefly as he blew through town en route to an International conference in Delhi. Such glimpses are a treat. My brother, Vinu, met up with us then, too, and that was fun. Anu and family came in at a different time, and found a flat for my nephew, Aditya, in our building. All are happy at this turn of events.

The boys are fine, and are prone to occasional whining about academics. I have gently pointed out their good fortune in various areas. Ha ha - not really; not gently; I have pretty much ripped their thoughts out, pointing out that there are children on the street who would grab the chance to study but whose parents do not have the means, there are children who have to go to work from the age of 8, there are those who have sacrificed beloved academics to educate a younger sibling or get him/her married. Whining about academics? Look elsewhere for sympathy and a gentle viewpoint. :)

Unw -

R

Report of 23 Nov '09

2009-11-22T21:44:00.000-08:00

Hello from the Banyan -

The airconditioner is blasting and I should not complain - at least we can afford it, sort of. Actually, it's mainly on to protect our computers, as the intense heat and humidity of Chennai can cause many things to fold: Tupperware lids, Rubbermaid containers have not stood a chance here. Even the legendary, lifetime guarantee Tupperware.

Fotb.usa@gmail.com - if you want info on donating, and availing the tax exemption for it.

Ms. SA, the patient with the stroke, apparently opened her mouth last week when the health care worker (hcw) asked her. All are beside themselves with joy. I have not seen this miracle myself, but will ask for your prayers to aid in the recovery. Our triumphs are small, but they can be mighty. A colleague mentioned the hcw's little jig when the mouth-opening first happened. I have requested that someone read to Ms. SA on a regular basis, perhaps we can capitalise on her improving cognition.

Ms. S is a patient with HIV, and she speaks a language none of us knows. She developed arm swelling last week and was taken to the ER at the magnificent Sundaram Medical Foundation hospital, which treats our patients for free and does a very good job. The ER doc saw the swelling, apparently some discoloration (I had not seen the patient at all), pronounced it a skin problem and referred Ms. S to the skin clinic. Our very sharp nurse, Leela, continued to go after the problem and ordered an xray on her own; lo and behold, a fracture - which has to be repaired by surgery. I sent a note to one of my colleagues at SMF, asking for the thought process of the evaluating doctor, and got a reply within hours, promising more info. SMF treats our (impoverished, destitute) patients ably and like all other patients, and my intent was not to find fault but to help the evaluating doc realise that a swollen limb could benefit from an xray. SMF takes all such feedback well; some hospitals - and doctors - could get completely irate at the questioning.

A few days ago, it continued to pour buckets and as I drove home in the rain, an old man asked for a lift. I don't ever stop, but it was wet and miserable, and I thought I could take the old man on if something other than a usual car ride happened. The man got in, told me his health woes quickly, and I asked him to go to SMF, then he mentioned his financial woes even quicker and fairly brazenly asked for money. I thought of my purse on the back floor, but have long learned from my husband not to cough up bucks for every sob story, so my charity ended with the lift.

I caught a virus a few days ago, and it was particularly virulent. My throat worsened exponentially overnight, and I developed a fever. My suspicion was very high for swine flu, but treatment for that is a song-and-dance here: go to a special facility with about 1000 others, get tested and then get Tamiflu if the test is positive. So I gave up that quest, gargled madly with salt water, poured all manner of hot beverages down my throat, and felt better. The men were good during this time, and attended to my share of household duties, and made soup and tea, and listened to me whine non-stop.

One of my able colleagues, Swapna, sent our cooks for retraining to a wonderful local restaurant. They have returned with deft new touches to their recipes, and all are benefitting. I have thanked Swapna profusely for this brilliant idea.

My sister and brother-in-law came into town yesterday and it was good to see them. They were flat (apartment)-hunting for my nephew, a lawyer. Real estate in Chennai is very expensive, and that is dispiriting; I have seen a couple of apartments that I really like, and we simply cannot afford them. Why? - my own darn fault. Were I raking in the bucks in private practice, I could have afforded my dream flat with ease. And right along with that thought, my sons hug and kiss us as they say goodbye, instead of saying "Ewwwww"; one son says a bunch of his friends and he want to help at an underprivileged event and could I get more info on it; the other son speaks candidly of temptations he's tried with his friends and acquaintances; my husband entertains his in-laws as lovingly as if they were his own siblings; we talk on the phone with my parents as we plan for Christmas; we play games on Game Night, eat junk and laugh out loud at some ridiculous turn of events; all 3 men and I bring up issues of our respective days, we talk and laugh; I get a smile from a patient with no family and no money after she overcomes a disease. Do I have riches - not the flat kind, maybe, but certainly, plenty, plenty of others.

Unw -

R

Report of 16 Nov '09

2009-11-15T19:04:00.000-08:00

Hello from the Banyan -

I missed blogging last week. University College, London (UCL) and the Banyan Academy of Leadership in Mental Health (BALM) ran a course on Medical Anthropology, and I was deputed. I enjoy courses and conferences. This one was well-run; when it dove into anthropological and "high funda" terms, I was lost. Dichotomy, paradigm, etc. - these terms, concepts and what they were used to elucidate were totally befuddling. There was a session on Faith Healing which was excellent; the B brought patients treated by a faith healer, and a faith healer, and it was cool to listen to them.

It is my belief that I am of lesser intellect than someone who can confidently discuss esoteric concepts. Folks talked of menopause in Japan, that it was different from menopause in the U.S.; they discussed Indian scenarios and others; some got passionate about the role of medicine. Through all of this, I sat, contributing only when someone said she did not believe mental illness was stigmatised.

At the B, Ms. M had an event. She was being escorted back to her bed when she collapsed. I went to help her up with another patient's help, and she collapsed again. She then lost control of her bowels and bladder, and was unresponsive to me. As I felt her pulse, she started to gurgle, and spit up, and the moment of crisis was past. Another patient there tried to summon help, and was unsuccessful; the glucometer that is supposed to be present in the sick room was not; there was no powdered sugar on hand to put in Ms. M's mouth; all these are issues I am going to have to discuss when we get together with the team next. When the patient trying to assist me was yelling for help, I could hear the staff nearby in the dining room chiding her, asking her to contact the staff member in the sick room; there was none. You see, we cannot discount matters when a mentally ill person cries for help - the reason may or may not be genuine, but we must always err on the side of caution.

Well, Ms. M got better soon after some sugar was put in her mouth. She was back to her usual sprightly self, but we sent her to the hospital anyway to get evaluated. As I was squatting next to her, holding her very light head in my hand and near a smelly mess, I evaluated my role in the situation, being placed between Ms. M's life and death. This has freaked me out as a med student and intern, but has since become fairly routine. It is good to check our own pulse first, as they suggest in "The House of God," and try to stay calm through a crisis. Fortunately for me, Ms. M started gurgling and puking, and those were good signs. I did feel pretty privileged, though, to be treating someone who had NO ONE else, no husband/sibs/friends/parents, to turn to; is there Godliness about - I imagine so.

Our cook's husband, Mr. P, was unwell and they had tried to call me when I was at the conference. My phone was on "silent" and I did not hear it; the next day I heard that P had had fever and an upset stomach. I guessed he had eaten out, and he had; his wife lovingly packs a lunch, which he eats. He must have had a snack or 2 outside, and this was affirmed. In the monsoon season, contamination is rife, and eating out is fraught with more risks than usual. I sent the young man some antacids, Tylenol, and stern instructions about what to eat and what to avoid, and he appears to be better.

The rains are here. The slum folks have moved on to the railway station platform for a modicum of shelter. They do not speak Tamil, and I do not know where they have come from. It is not uncommon to see folks from other states here: we are a relatively peaceful place, with abundant religious tolerance, and a long history of hospitality. There is no dorm space in Naren's college, because young people have come from many miles away to study here; there are either no good colleges in their states, or violence precludes normal activity. Scott said the other day, after yet another bomb blast in Pakistan, that we think nothing of sending our sons by public transport, or out to gad about on their own. Blessings exist in many forms.

There were some fine times in the last couple of weeks. Scott and I went to hear a band cover the music of "The Eagles," and they were good. Navin joined us (Naren being off to follow up on climate change and Bhopal's 20th anniversary) to see a fantastic performance on dances of India - there are so many, and all so beautiful - by our legendary Kalakshetra, to raise money for marginalised kids. The boys and we saw some movies together. Yesterday, the men took turns to prepare the meals for the day and do household chores; this was the first time in my married life that I was completely free of household responsibilities and it was quite nice. Naren volunteered at a medical camp for underprivileged children, and discovered that it was being run by a friend of his, Archana. Navin is to volunteer for something similar in a couple of weeks. The great thing about such ventures is that a group of young people gets together, runs it, has jolly good fun hanging out together, and by the way discovers the fantastic joy in doing for someone much less privileged than themselves. Archana apparently sponsored lunch for all the impoverished kids at the camp, and Naren said there were so many other ways she could have spent her cash: iPod, a new outfit, CD's. I like the way these kids are choosing some of their friends, and their activities.

The big dilemma for me now is that one of Navin's friends strikes me as being not right for him. I have said it, Scott has requested me not to, and I am trying very hard not to harp on it. It will be a lesson for me in "Keep your mouth shut 101," which I have legendarily flunked.

Happy Thanksgiving to all in the U.S., and to all elsewhere, Happy November!

Unw -

R

Report of 2 Nov '09

2009-11-01T21:42:00.000-08:00

Hello from the Banyan -

The flower display - in a wide flower pot of water - has been replaced and looks lovely. I have eaten my 2nd breakfast and feel fortunate to be able to do that, especially when I have walked through the open-air slum this morning: the children ran about and played happily, but it was evident to me that there was no food in their bellies. You know something, though - that did not diminish their happy play any.

The Banyan has been doing well. Our health care workers (hcw's) are getting trained weekly. These young women are from very impoverished families in the villages around, and are great joys. I like interactions with them, and consider the work they do - be around the mentally ill residents 24/7 - to be very important. These employees are given room and board, which is a big bonus in our expensive city, so they get to save almost all their salary and send it home. They live in Adaikalam, so can't be too far away from the residents. Last week's training was on heart attacks, and was a raucous, interactive affair. I took some sweets that Naren had made, and the hcw's enjoyed them; I was then asked if I was grooming my sons for matrimony and I said, most certainly, I want my daughters-in-law to be grateful that these characters cook.

One of the social workers has just returned from a "rehab" trip - taken the well-recovered and functional residents back to their families, this time in North India, long train rides away. One of the patients, Ms. M, is a very attractive and personable lady. I found out from the social worker that on arrival at her far-off village, her mother had stated she did not want Ms. M back, and the team had no choice but to return with Ms. M to Adaikalam. Ms. M had, naturally, been disappointed but had recovered in spirit. I was very sorry to hear this story, that this patient's family had spurned her. How fortunate are those of us to whom this does not happen.

Some great times last week. There was a concert to promote climate change, organised by hordes of young people, and hosted by Naren and a young schoolgirl named Manavi. The music was good, and the info presented in a very good way, accompanied by yells of "We love you, Naren!" Navin came to the event with 5 girls. Yesterday was the complex's talent show, and the boys did not sing at all well, but ripped the stage dancing to a Tamil song - "Naaku Mukka." After the event, several neighbors said they were surprised to see half-White kids dancing to a filmi song, and with perfect Tamilian steps. It was great; we cannot listen to music without heads bobbing - or getting up and tearing the floor up.

We had a bunch of friends and neighbors over for "High tea," and Scott and I cooked the food together with the boys. It was a fun time, and the boys got lots of accolades for their parts in the cuisine.

Our cook's neighbor, Ms. K, has been taking her husband, Mr. P, regularly for reviews with the Banyan psychiatrist. Mr. P is back on his anti-psychotic meds and is slowly getting to functionality. This has apparently energized the other neighbors, who are now sending consultations to me through our cook. Works for me: medical attention in any form, if necessary, should be within reach of all.

Unw -

R

Report of 26 Oct '09

2009-10-28T01:31:00.000-07:00

Hello from the Banyan -

It has been about 6 hours of addressing emails, and several other issues. Somewhat exhausting, but necessary as this is the first chance I've got this week.

fotb.usa@gmail.com - that's the email address for our tax-exempt entity, in case anyone in the U.S.A. wants to donate, and avail a tax break. It was accomplished by a remarkable friend of the Banyan named Hema Venkatramanan, who is a wonderful, caring, giving human being. Hema can ably answer all your queries. I understand a similar entity is planned for, in the U.K.

The monsoon is on us. It started yesterday, and we are grateful that the windows in Adaikalam are getting fixed so that our poor ladies can stay dry.

It is also, apparently, the time of year when the teenagers decide to unleash massive doses of selfishness. I probably should be a gentle mother, pointing out the error of their ways. Instead, everyone got a dose of wrath this morning, and thunderous consequences. As I told a friend, if we did not routinely have such turbulence, we might never appreciate the peace. And you know, I was 100 times worse when I was their age.

The lady who's had the stroke has a huge bedsore. Last week, I asked to examine it and found it infected and very, very smelly (malodorous). I started an antibiotic, and asked that she be turned every hour instead of every 2 hours. I looked at the wound again yesterday, and it is better! HOOOOO! Our triumphs are small, but they are mighty.

I took the train this morning and had to cross a huge open-air slum by foot to get here. The kids in the slum had put stones across a giant puddle so that all could cross without getting too wet. I was touched by their thought: in the midst of their staggering poverty, they spared a thought for people who essentially would not give them a second glance. How many of us would be similarly kind?

I got a package of journals and candy from some former colleagues in the U.S. I was very happy to see the journals and the family was elated at the candy. Food of a different kind, for each of us; where would be without diversity.

Unw -

R

Report of 19 Oct '09

2009-10-18T23:09:00.001-07:00

Hello from the Banyan -

I trust everyone had a good week. On Saturday, the whole country celebrated Deepavali, or Diwali. It is a triumph of good over evil, in Hindu mythology, and celebrated with lighting lamps, new clothes for all (a major investment for some) and sweets. Once I had a patient who was critically ill, who refused to spend the money for a CT scan as she had to buy new clothes for her daughter and son-in-law. I had a discussion with the latter folks, and they bemoaned their mother's priorities also, but no one could do anything about the decision.

In our house, Naren and Navin make the sweets. The recipe is simple and tasty, the best kind. All the neighbors know who the chefs are in our house that day, and the boys love the accolades. We make the sweets the night before, or some days before, and get up early on Diwali, have hair washes, put on new clothes and go down to set off fireworks, which the boys have since outgrown. After breakfast, the boys distribute the sweets to neighbors and we sit in the house, receiving the platters of sweets and savories that come from neighbors. Some folks have friends and relatives over for a meal; for us, Diwali is family time and we plop in front of the TV, eat junk ad infinitum, and watch movies until someone says stop (usually I).

The Banyan had a musical group come on Thursday to perform for the residents and filmi songs were played. The residents had a nice break in the daily routine, listening to the peppy music. I was moved: here were a bunch of women, destitute, combating mental illness and family weirdness, overcoming ostracism and trying to make a life for themselves, listening to music and getting a little therapy for their souls. Rhythm is in our bloodstream; many of us cannot listen to music without feet tapping or head bobbing. One of the health care workers told some of the patients to dance and dance they did - with rhythm and joy - and it was a cool sight. As the cast of "Slumdog Millionaire" told questioning reporters at the Academy Awards, everyone dances in India.

A. R. Rahman, who won 2 Oscars for the music of "SM," had a concert here last week and it would have been nice to go as we are firm fans. However, as we age, the thought of giant crowds and battling traffic simply does not constitute a good time for us.

One of the patients, Ms. M, is a fairly permanent inhabitant of the sick room. Her gait is unsteady and she will fall if she heads off to the dorm; I have requested our able physical therapist to work with her. Ms. M has been abandoned by her lawyer husband, whom the Banyan has sued and won monthly support from. This check goes directly to Ms. M, and she spends it as she wishes. Often her list of expenses includes a cup of coffee for me, which I have to decline as I don't drink it. I am *always* touched by the thought, however. Ms. M also asks unfailingly about my children and my husband, and last week, stated that her son had bought her a new pair of spectacles. She does not have children - considered a huge personal misfortune and a slight on the woman, not the man, in India - but all of us played along with her delusion, not wanting to give her the impression that she was an unlucky sort, and giving her some perceived commonality with other mothers on the staff and me. We aim to please.

All are well here, and we hope the same with you. The teenagers tend to launch into some exhausting battles with us, but you know, it is markedly better that they verbalize their anger and duke it out with us than find some other ways of coping. We do not have a functional TV in our house, and the boys read a fair amount, consequently; as such, their arguments are often well-thought-out and well-informed. They are, like their father, cool young men and I am quite, quite privileged to have these folks in my life.

Unw -

R

Report of 14 Oct '09

2009-10-13T21:42:00.000-07:00

Hello from the Banyan -

Always good for the doc to know what it feels like to be a patient. I have a stomach ache today and have been short-tempered and irritable. It does not hurt to be this way at the Banyan; as Scott's friend, Craig, and I discussed, it's always good to have a bit of an edge if you want to get anything done. Niceness does not go very far at all.

The B has been good, but with "creative chaos," as our new CEO calls it. Everything is done at the last minute, with massive pandemonium and late nights, but it gets done. I can't usually work this way in the medical world, and thus there is a lot of adjusting to do. But there is grand good humor all around, and we can live.

I am thunderstruck to find that Ms. SA, whose recovery from a stroke was so magnificently achieved by our physical therapist, has had another stroke. Her blood thinner had been inadvertently left off her list of meds, and she had not received it for a lengthy period; I am trying to find out why. And now, the second stroke. It is a massive stroke, and the patient can respond to her name, but that's all. I look at her, and I consider her present condition a personal failure; yes, I was not here when the error occurred, but that's irrelevant as it is my team that takes care of this patient's affairs, especially medical. And I am in charge of said team.

On a good note, one of the sweepers at the B had told me a couple of years ago that her adult, married son was not to be seen or heard from. She had asked his in-laws and replies had been vague. She is a widow, with an only child, and wanted to find her son. Having 2 of my own, I could completely relate, and thus spoke with Vandana (one of the founders of the B) and the social workers, and a massive effort was planned. The first step involved procuring his photograph, and the lady did not have one. The exercise looked like it would be derailed before it began, but no one wanted to give up. So we kept after the lady to get his photo (maybe from the in-laws), or ask relatives, or inform us his last point of contact, etc. I used to get periodic updates from her over the years as she consulted astrologers (very, very common here), investigated with relatives, etc. Yesterday, I heard from her that he had been found. I was elated! He has remarried, apparently, and the mother states that there is little she can do about that. The first wife has stated she does not want any part of married life; it is not unheard of at all for multiple wives to maintain separate households and lead some kind of lives, though polygamy is eminently illegal in Hindu law. So there we are; I am very happy that this mother has located her son, and it so showed in my eyes that this lady pinched my cheeks and kissed her hands, a gesture used to show affection.

Some fine times last week. A nice volunteer from the U.K. named Karen spent a night with us and that was fun. Karen is married and has a stepson, and we found we could talk about all manner of things; wifehood and motherhood are so universal, aren't they. The men enjoyed meeting Karen as well. For Game Night this week, we played "Outburst Junior," and it was hilarious, as any game with the boys is wont to be. The game involves narrating a list of examples of a particular title, e.g., "Girl Scout Badges," and the boys deliberately distorted sane titles such as those to "Species of Turkey," and "Broccoli-eating Weasels." It was a blast. On Sunday, the boys and I saw a Tamil movie called "Eeram," while Scott was at a meeting of the committee of our apartment complex (the president had asked me to be on the committee and I'd pointed out that Scott was a much better candidate, being rational and intelligent and patient). Then all 4 of us saw "X-Men Origins: Wolverine." I, of course, salivated at Mr. Jackman, and the men enjoyed the movie for reasons of their own. The boys then went off to see a play, and Scott and I (being big Richard Gere fans) saw "Nights on Rodanthe," which was dreadful.

A vat of chocolate pudding was made on Sunday, which is a communal endeavor: someone has to dissolve the gelatin, someone makes the chocolate sauce, yet another the coffee, and then the whole mess is whisked together to make a somewhat foul dish, but one the men enjoy. The joy is in cooking together, and for me, marvelling that the men eat this stuff.

Unw -

R

Report of 5 Oct '09

2009-10-04T23:16:00.000-07:00

Hello from the Banyan -

Trust all are well. I got back to work last week, and it has been fabulous. It is wonderful when work rounds out a part of your soul, fills a part of you that was otherwise empty or had been beaten up, when folks who have very little can be made to heal.

As I tried to get caught up at the Banyan, saying hello to the myriad folks, catching up on people's lives and healed mental illnesses, I noticed a young woman sitting in the middle of the chaos in one of our upstairs rooms and studying. One of the psychologists/social workers told me that the young lady had had a relapse, and was back at the B from her family's home. The B is treating her, wants her father to come in for a meeting, and he has refused. The young lady is studying for her pharmacy degree, and I was very impressed that she could find the wherewithal to focus in the middle of a multitude of people wandering back and forth, yelling on occasion, or bustling about as they went from activity to activity. The social worker saw my admiration and asked if I wanted to be introduced; I said yes, and went and met the patient. I told her how happy I was that she was studying, that if any of us could help in any way, not to hesitate to let us know. I am always tremendously impressed when folks overcome staggering odds - in this case, mental illness and an unsupportive family - to pursue education.

One of the sweepers (custodial staff), Ms. K, had lost her son before I left for the U.S. I had condoled with her then, and told her of my own mother's loss of her first-born, and we had comiserated. The bereaved have a unique and tragic bond with each other. She came up to me again this time, and reminded me of that conversation: "I still miss my son," she said, "he should have done the last rites for me, and I had to do his last rites." "That is exactly what my mother said, too," I told her, holding her hands in both of mine, "and this is something all of us must live with." "It has been a year," she said, "and I still think of him." "It has been 11 years," I said, "and my mother too misses her son."

We are pleased to tell you that Lufthansa donated some cash for our upkeep, and we have managed to get some windows repaired at the B. This is crucial, because the monsoon is almost on us, and I find it imperative to keep our women dry and warm. Thanks to those who see fit to help us.

Some fine times last week. 2 Oct was Gandhi Jayanthi, Gandhi's b'day, and a holiday. My widowed sister-in-law, Susan, came to visit us with my niece, Sanjana, for a couple of days. Susan is a lovely person and good fun, thus the visit was nice, and Sanjana enjoyed being with her cousins. On the 2nd, Anu and family, and my younger brother, Vinu, joined us for lunch. It was grand fun, and we overate, talked and laughed. It is customary to poke fun at each other at such times, and this occasion was no different. I feel particularly happy that Scott gets along with in-laws and can tolerate their presence for extended stretches. We also went to the beach as Sanjana wanted to go, and saw a very nice Tamil movie - "Thiru thiru, thuru thuru."

One of the hospitals that treats our patients for free, SMF, held its annual conference over the weekend and it was excellent, as usual. Starting on time is quintessentially rare in India, and SMF is the exception, to my great delight. One of the highlights was a cardiologist from a small town who has trained several local primary care providers from villages around to recognise major heart problems; he presented a nice talk on heart attacks, and 3 of the primary care docs joined him for a case discussion which was the highlight of the conference. They discussed extremely pertinent ways to diagnose serious heart conditions in the absence of fancy imaging equipment and other technology, with purely physical diagnosis; this was invaluable for me, as my patients simply cannot afford expensive tests.

The men and I had Game Night yesterday, playing Taboo. It was a hilarious exercise and a very fun time. I have been privileged to get nice emails from the U.S., and there were several people I met at the gym while working out there who have written. Teri (a personal trainer of considerable skill), Joe, Chris, Natalie and David are exceedingly nice people, with kind hearts and souls and spirits that one recognises as kindred, and I have enjoyed the notes.

Until next week (Unw) -

R

Report of 28 Sept '09

2009-09-28T08:26:00.000-07:00

Hello from my Chennai living room -

The ethereal voice of George Harrison is playing, and I am blogging. This CD was one of two things that I bought for myself and I love it. The other purchase was tap shoes.

Things have settled into a routine quickly. Our cook said her neighbor had been waiting for me to return, and the neighbor, Ms. K, brought her husband home last week. They had stopped his anti-psychotic meds on their own, and the man's mental illness was back with gusto. I referred them to the Banyan, and the good psychiatrist there is treating the man appropriately. This couple has very little money, like most of my patients here, and the Banyan's free treatment fits their wallet; some blood tests had been ordered, which the couple has to pay for. The lady mentioned this repeatedly to me, in the hope that I would cough up the cash, but those intentions and days are long gone. When I first moved here, I nearly opened my wallet the first time a patient said she could not afford her meds, but did not; later, my very prudent husband suggested I not adopt this practice, because then not only would I be known as the doctor who had come from the U.S., but also as the idiot who doled out cash to anyone who sang a "panja paatu" - literally, a famine song, or a narration of want. As everyone knows, there would be plenty of scope for abuse there.

The neighbor downstairs stated that her maid was in agony with belly pain. I examined the 18 year old, and it seemed like she had an ulcer; I prescribed the appropriate meds and she is better. I have been burned before with an unmarried maid of another neighbor, who complained of belly pain; on persistent probing, she denied all possibility of pregnancy, and later ended up indeed admitting pregnancy. Craig Witz in San Antonio, my OB professor, stated that belly pain in a woman of child-bearing age is pregnancy until proven otherwise. Such lessons are good to remember. I feel for these maids; they leave their own impoverished families at fairly young ages, and work for employers whose treatment of them might or might not be humane. It is a matter of tremendous good fortune and privilege for me that we can afford to keep our sons with us and raise them.

We visited Madurai over the weekend and spent some fine times with my parents. My mother is disabled, and in a wheelchair; my father is her primary caregiver, along with managing his practice and lecture schedule. Their sense of humor and grace are firmly intact, though, and we spent the whole weekend laughing and eating and enjoying each other; it was rejuvenating, and we returned this morning. The boys and I went out for breakfast this morning, which was wonderfully good fun, and after dosais (a kind of rice crepe), we went to wish my friend, Joan, on her b'day. Joan and I met when I was 16, and have been friends for 30 years, the sort of friends who ask about each other's families, eat all the food in the house, and revel in the company. Joan has 4 children, the second of whom is developmentally delayed; as we went in to her room to see her, Prarthana (the name means "prayer"), perked up at the sight of my sons, and was particularly delighted when Naren played music on a guitar for her; it was indeed fine playing and I felt my eyes pricking as this beautiful disabled child responded to music and a visit from my sons who are realising daily that there are folks much less fortunate than themselves. Joan's family is well-off and my sister, Anu, and I have felt happy for this, that Joan can afford the care for Prarthana that she needs.

A dear friend of the family, Uncle Subramanyam, passed away on Saturday. He was 92, and a friend to all manner and all ages of people. His advice to us in raising the boys, in our careers, his ease of manner, his powerful sense of humor, his acceptance of all who entered his house (one of his triplet grandsons has married an American, and the other 2 of the triplets married outside their community also), his holding his family together - all these were awe-inspiring, and therapeutic to recollect as we condoled with his family today. We are extremely privileged in those folks who are in our lives. Scott said Uncle Subramanyam waited for me to return before he left this world, and that was a kind thought.

I made macaroni and cheese for the family today, a great favorite, and easy to make, even from scratch. It actually does not taste very good at all, but since the men fairly inhale it, I make it. Such routine chores are quite a joy, since I have been away from them for 3 months.

It is lovely to be back, to take care of the poor, to share my skills. That everybody were this lucky.

Unw -

R